tv Health Human Services Secretary Testifies on 2022 Budget CSPAN July 28, 2021 11:27am-2:43pm EDT
active in the orientation. and she was very upset about what was going on. her and i chatted and she said, what can i do, and said go back to the cloak room, and put a video on the social media and if you have any influence ask them to stop, and she did that. and also, more testimony for views from the house sunday on cspan.org. up next, testimony from xavier becerra's health and human services secretary hearing
on matters of the border. >> good morning. i want to welcome everybody, and thank secretary becerra for being with us. and this is rules pursuant to house resolution 8. before we begin, i want to remind the members of a few procedures to keep these procedures running smoothly. first, consistent with the regulations, the members will keep the microphones muted to limit the background noise. and members responsible for unmuting themselves when recognized for their five minutes. committee staff will mute the members only in the event of inadvertent background noise. in addition, when the members are present in the proceeding they must have the cameras on. if you need to step away to attend another proceeding, please turn the camera and audio off rather than logging out of the platform. and finally, in the event that i experienced technical difficulties or i need to
momentarily step away from the moment, congresswoman del bene will be the chair. and so with that, we proceed with the department of health and human services secretary becerra. i extend a warm welcome and all of the welcome from the members of the committee. after a nearly year and a half of devastation, and economic uncertainty and loss of million and a half of american lives, we meet with renewed optimism as our nation makes streeds to eradicate covid-19. thanks to president biden's leadership and the diligence of the health workers and everyday americans, the coronavirus cases and hospitalizations and deaths have dropped dramatically, this progress is in no small part due
to the availability of vaccinations due to americans over age 12, and however, there is still much work to be done to reduce hesitancy and combat misinformation regarding the vaccine. i am impressed with the creative steps that the administration is taking to encourage americans to get vaccinated as well as the efforts to eliminate barriers to get the shot such as lack of child care and transportation. another critical issue that is threatening the health of all americans, and also the target that we all understand of misinformation. and as it relates to climate change. climate change is real. it is a tremendous threat to our planet and to the health of all people. secretary becerra, i recently sent you a letter asking hhs to pursue a policy of combatting climate change, and to reduce
the carbon emissions, and make the efforts more sustainable. so i am certainly looking forward to your partnership. a topic that i know is near and dear to your heart is affordable care act, and a law that this committee played a key role in authoring. in the short tenure of hhs, mr. secretary, you have shown how you can expand the reach and the positive impacts. 31 million americans now have health coverage through the aca thanks to the accomplishments over the last 11 years. and more than a million additional people gained coverage through the marketplaces in the last four months. there is still more work to be done, and for example, the 12 states have adopted the medicare expansion, and many more millions of vulnerable people with coverage for purely political reasons. i'd lick to hear your thoughts to ensure that everyone who needs coverage gets it. i was pleased to see that the
advanced premium tax credit will help people to get their plans to make it permanent. that is the type of the actions that can ensure the population, and to help those covered by the aca to stay covered. while the affordable health can fall prey to exorbitantly high cost of charges for their care and billing. at the end of the last year, congress acted to address the crisis with bipartisan legislation to protect patients from surprise bills. i want to thank ranking member brady for the solution that congress ultimately came up was a balanced approach centered around strong consumer protections. now it is up to hhs to implement the law, and i know and hope that you will work closely with us as you proceed. another area where your agency must take urgent action is
nursing home safety and quality. the pandemic's horrific impact on these facilities laid bare the long-standing challenges in that industry. vi spoken to your predecessor a number of times about the topic, and sent a number of letter about this matter, but too little reform. i am counting on you to make the regulatory changes that congress legislates. just as the pandemic illuminated serious problems plaguing nursing homes, but it brought to the floor a number of substantial problems brought to the working families in the united states for many years. the lack of paid leave and inadequate child care existed long before covid struck, and that means that the democrats released the building, and the economy and the families' act, and the draft propoal is to make sure that it works for the working families. the hhs is going to be responsible to implement the
policies that we put forward and we can count on you the implement the changes to make our economy more resilient. and lastly, i want to address a issue that touches every topic that which have raised this morning and one that you and the president cares deeply about, and that topic is equity. the ways and means committee is a leader in attempting to address the inequities in the society broadly. and be pleased to know that we have done bipartisan work in this matter. and we have worked in the rural underserved communities and our task force has led the way. one specific inequity matter that i know that we want to raise is the need to increase diversity in the workforce. so i want to get your commitment to have a pipeline of practice program to increase the minority doctors in the workplace, and this is going to deserve
attention, and i want to introduce legislation in this matter. this is just a scratch of the surface of the problems of the nation, and your agency in particular. i am pleased to see an esteemed ways and means alum at the head of the hhs at thispy toll time. i look forward to your partnership as we look forward to improve the health and well-being of the american people. with that, i look forward to your opening statements. >> thank you for holding this hearing. it is great to welcome back a friend of the house ways and means committee, secretary becerra. at a time of this economy, the administration is proposing a
crippling tax increase. and the proof is the jobs report, and the recent setback, and recent fell short of the dumb down job expectations. long term unemployment is long worse than before the pandemic, and the workforce has regressed to the 1970s. despite all of the advantages that he inherited including tril trillions of new stimulus spending, he is half a billion short of what president trump achieved in last five months in the height of the covid tests. so there is two pinocchios to president biden for false claims of the job creation. it is clear we don't need more stimulus, but better economic policies. so despite the differences, we have worked together to find common ground in health care,
foster care, and medicare improvements, and telehealth, and covid aid, and mortality, and helping the underserved communities and leading the first ever ban on surprise medical bills. regrettably though, the hearing is going to reveal a budget that is truly partisan. after a massive pandemic, president biden insists on putting washington in charge of personal health decisions even if it means canceling their personal health care through medicare for all, and through devastating diseases, and hr-3, and the costly one-size-pit fits-all mandates, and illuminaing the di solving of medicare, and also putting the irs in rnlg challenge of your time off, and doubling down on the unaffordable care act. americans don't trust washington
with their life and death medical decisions. they oppose a socialist takeover of their health care. they know the good paying jobs and the high paying wages do more for a family than one-size-fits-all washington mandates than smaller paychecks. americans don't want lower drug prices at the expense of future cures for alzheimer's, parkinson's, and diabetes and cancer as the democrats are rushing through the house in hr-3. they want congress to work together to deliver lower drug prices and more life-saving cures as republicans proposed in the bipartisan hr-19. and instead, democrats make it worse by expanding the program
beyond the fact that seniors have paid a lifetime into social security, and telehealth may be stripped for those who relied on it to get through the pandemic, and another problem ignored in the biden budget. it ignores the failures of affordable care act and acknowledges that obama care has done little to address rising health care costs. that is why the biden budget spends another $160 billion over the next decade without addressing the real problem of continuing rising costs. and yes, puts irs in charge of your time off from work while permanently shrinking the paycheck of every american worker whether they use paid
leave or not, and president biden is continuing to ignore the border crisis that is treating so many young people cruelly and putting their lives at risk at the hands of dangerous coyotes and now american foster children are also hurt as the biden administration diverts foster care funds that push american's foster kids out of their homes to make way for migrant children. this crisis has made its way into the communities across the country, and it is making worse the challenges facing our foster care system. just last month nearly 300 children in texas had to seek shelter in a office, hotel or church, because there were no open beds in our current foster care system. i hope that you, secretary becerra, as we have discussed can shed light on the agency's handling of the crisis and the more than 18,000 unaccompanied kids in your care.
there is too much at stake to get this wrong, whether it is health care, foster care or budgets, and president biden in our view is the last thing that we need. and so we should and could go a different way, and we can tackle enormous challenges by working together, and i hope that is what we do. secretary becerra, welcome back to the committee, and chairman, i hope we take a step in that direction today. i yield back. >> thank you, chairman brady. all of the opening statements will be made part of the record without objection. our witness today needs no introduction. chairman becerra is the 21st secretary of the health and human services. he was a member of the house of representatives and a member hoff this committee until 1997 until he was appointed attorney general for the state of california in 2017. mr. secretary, we appreciate your presence here this morning
and we have received your written testimony, and it will be made part of the record, and we ask you to summarize the testimony in five minutes, and we ask you the pin the time at the bottom of the screen, and i will notify you when you are near the end of your time. >> thank you, chairman, leader brady, and i appreciate the opportunity to come back here to talk about the crises. and now more than ever, we must make sure that hhs has the budget to complete its mission. this budget underscores the administration's commitment to
prepare the nation for the next public health crisis, and expand access to affordable health care, and address health disparities and tackle opioid and other health crises and other priorities like maternal health, and tribal health, and early childhood education, and the fight against covid-19 is not yet over, butted as hhs is working to beat this pandemic, we must also prepare for the next public health crisis. to start, the budget makes significant investments in the preparedness and re responsibilities. and it provides for a new mandatory funding stream for the counter measures here at home to protect americans from future pandemic and to create u.s. jobs. the budget includes largest fiscal year investments in the cdc in almost two decades. the budget reflects president's commitment to expanding access to affordable health care for
all americans and for the groundbreaking reforms of the american rescue plan by extending the enhanced subsidies that put affordable health care within reach for millions of americans and the budget is going to expand access to home, and critical services that allow older americans and the loved ones with disabilities to live independently in the homes and communities, and the budget calls on congress to take additional steps this year to lower the cost of prescription drugs, and expand health coverage to additional benefits of public coverage options. health care must be a right and not a privilege and i will work to make sure that families across the nation are able to secure the health care they need. as we work to expand affordable health care, and address the challenges of the crises that are here like violence in the communities, and the president's
budget to increase domestic violence, and addresses gun violence of the prevention, and allows hhs to play a role in the government-wide efforts to tackle the climate crisis by supporting research and the human health access and climate change equity. to ensure that hhs is equitably serving all americans to address maternal mortality and morbidity that disap proesh natalie impacts women of children, and establishes a rural health care programs and expands the pipeline of rural health providers and it includes a dramatic funding increase, and advanced appropriations for the indian health service. it invests as well in providing access to preventive health care
services in title 10, and the budget makes major investments to ensure high quality health care is affordable for low and middle income families and to provide high quality pre-k for all 3 and 4-year-olds, and we know that the experiences as children shape the adults that we become. support in childhood is going to lead to the success in the future. to address the covid's increase and drug abuse, and samsa's research and also to increase research in nih of $9 billion of $6.5 will go to arpa-h for prevention of diabetes and alzheimer's and other diseases. and this going to provide
innovational research and application and implementation of health breakthroughs, and finally to ensure that our funds are used appropriately to combat waste, fraud and abuse in medicare and medicaid. and mr. chairman, i would like to recognize the men and women of hhs for their tireless work of fighting covid-19, and to have a prosperous america, we have to have a healthy america. we have been looking to lower health care premiums and protect men and women at home and abroad. and this budget would provide that, and i thank you at this time.
>> i think that the chairman is muted. >> mr. chairman, i believe that you were muted, and so we did not catch what you said. >> okay. we will try it again. >> there we go. >> so without objection s each member will be recognized for four minutes to question our witness so that we may ensure that all members have the opportunity to inquire before the secretary is scheduled to leave. he has to be at the senate this afternoon and consistent with the committee practice in these remote settings, we will go in order of seniority between the majority and the minority members, i will begin by recognizing myself and i will bring down the gavel in four minutes and the secretary has asked for that courtesy and so we will extend it. mr. secretary, i would like to address the low income gaps in
some states for those who have refused to expand medicaid, and we have talked about this issue. i know your answer, but want to get on the record as well that the 2 to 4 million americans cannot wait any longer to coverage, and congress should find the most expeditious path to go forward. >> mr. chairman, we agree completely with the administration to expand health care, and 231 million americans have received health care through the care act, and through the special enrollment period issued by the president, more than 1 million americans have been able to receive health care coverage, and we will continue the expand it whether it is under medicaid or the marketplace, and we want to explore all of the opportunities to continue to give all americans the opportunity to have health care as a right and not just a privilege. >> thank you. mr. secretary, similar to the ways and means draft of building
an economy act, the president proposes an investment in child care to make it more affordable, and available, and upgrade to make it safer and better and raise the wages for the child care workforce which is as we know predominantly women of color. could you tell us more about how making this long-term investment in child care in the arpa is still needed to support workers and families. >> mr. chairman, first let me begin by thanking you and this committee for your work on the building an economy for families act, which i know is crucial if we're going to continue to move forward to help our children. our budget proposes $3.5 billion for the child care enactment titlement of 2022 and provides for further investments in our
work force in the child care field. we want to continue to give americans the opportunity to explore any job opportunities they like because they know they'll have quality, affordable child care at their disposal. we look forward to continue to expand access to child care for all americans. >> mr. secretary, the covid-19 laid bear the inned a ksy -- and make long-term investments such as improve staffing, oversight and transparenciy. could you speak to the actions hhs is currently taking to improve quality for residents and staffing? and could you speak to that.
>> absolutely, mr. chairman. we learned, from covid-19, how much we need to do a better job at being able to track what's going on in the various facilities. we need to work closely with congress to insure we're providing to our families the protections they deserve and have safety as a paramount concern. $75 million to increase abilities to address additional complaints that may be lodged by patients to perform infection, surveys in nursing homes and provide an annual mandated survey in nursing homes. we intend to do the proper oversight of various facilities that house our loved ones. >> thank you, mr. secretary. mr. secretary, thank you.
let me recognize the ranking member for five minutes. >> would you yield to enter some to a brief [ inaudible ]. >> yes. >> thank you, chairman. for too many years too many patients and families had their health care compounded by an unexpected medical bill. thanks to the bipartisan work of this congress, this practice will soon be no more. now it's up to the biden administration to implement this law. i want to reaffirm our shared rifor orts in the ways and means committee. we aim to protect patient's access to providers in their area. and we sought to take patients out of the process in an effort to tip in favor of one party or
the other. this will enable independent arbiters to weigh in a given case and keeps it from becoming a defacto rate system. the integrity should be protected in as many ways as possible, including through robust transparency. and in accordance with the timelines we wrote into the bill. they deserve a prop payment on resolution of these. finally, i would urge them not to neglect the transparency measures but a focus on the historic, advanced and honest and true bill implementation of benefits provision. giving them information on the cost of services ahead of time will help health care make sense. nobody fills up their tank wot knowing how much gas costs.
the same should be true for health care. mr. chairman, i appreciate your indulging me while we have the secretary before us. and i look forward to continue to work on this important issue and i yield back. >> i want to fully associate myself with remarks. and patients must be protected from out-of-networks prized bills. they subsequently get a bill they supposedly agreed to pay. we look forward to continuing to engage with the administration as this law is rolled out. >> so, if i may start. >> gentleman's recognized.
>> thank you. i think there are several areas of common agreement, including making america medically independent from china in crucial medicines and as well as insuring the telehealth, which is one of the saving graces in the covid can become permanent access and flexibility to connect our patients with their health care providers. this is unaccompanied minors. they've been streaming across the boarder in unprecedented numbers for months. i've been there. i'm concerned the administration is in denial about this and has
no plan to address it. so, i've written two separate letters on this issue. i ask both be entered into the record. >> so ordered. >> my understanding they'll be unified with sponsors. i believe it's roughly 10% of unaccompanied migrant children have no sponsor and need some sort of long-term foster care system. the problem is our foster care system is, frankly, overwhelmed, and cruel. in the knowledge that this is already hurting some of the u.s. foster kids as we try to get a roof over their head and foster parents. what is your plan to protect american foster kids with this system, anticipate and manage
increased need for foster beds? >> great to see you and thank you for the question. very much looking forward to working with you, especially on this issue to help our foster kids. let me assure you all the work we're doing with unaccompanied migrant children, and we have a responsibility to provide them with health and safety while they're in this country, however long that might be. we won't let that impact the work we're all doing to care for the foster children throughout our country. they run on different tracks. but that with regard to migrant children and with regard to foster care. and we'll continue to keep them separate. >> so, when, from a time table standpoint, when might we see a plan on how to address the issue, one where republicans and
democrats can work together? >> i'm glad you're asking that question because we're looking at a budget -- our budget, essentially that we're looking to come up with long-term solutions. we know that the phenomenon of seeing migrant children at the boarder unaccompanied is not new. we intend to come up with a solution that doesn't have us gyrate in a process through the year to come up with long-term solutions. it is expensive anytime you have custody. and need provide health and safety to children. we look forward to coming up with long-term solutions. >> thank you, mr. secretary. thank you, mr. chairman. >> with that, let me recognize the gentleman from texas to inquire for four minutes. >> thank you, mr. chairman and
mr. secretary for your important leadership. my home state of texas has the disgrace of having more uninsured children and people in america. we've learned that, as many as 2 million texans could get access to unfortunately, ideology gets in the way of caring for citizens who are vulnerable and economically disadvantaged. i want to bring to your attention another one. and that is to authorize
medicaid this would be a way to have a healthy option and extend medicaid to them on the same basis in a local area, through a county, a hospital district, a city as has occurred in most states have you worked on this alternative that will be included in legislation i'll be introducing with probably just about every democratic member from the 13 expansion states. >> i think we lost mr. dogt.
>> shall we wait? >> we'll give him another couple minutes and then we'll come back to him, or at least allow him to finish his question and you to give an answer. we'll come back to mr. doggett. >> thank you. everyone, appreciate the time today and thank you, mr. secretary, for your attendance today. to be prepared for the next pandemic we must have robust manufacturer in pharmaceuticals. if we're going to continue to be the world's leader in innovation, we can't leave ourselves vulnerable to china when it comes to this critical issue. this is why i introduced two bills in the last congress and
why i'm concerned about the biden administration's support for the trip's waver, which would force them to share information with more nations, including china, russia and other hostile regimes. because of the way it clearly jeopardizes vaccines and cures, i introduced another bill, analyze implications and protect u.s. national security before waving any national vaccines or protection. hhs should play a central role in analyzing the waver's effects. in both the united states and globally. it's critical we assist the global distribution of covid vaccines. but a trip's waver, which is opposed by allies like germany, would take years before yielding
large numbers of vaccine doses abroad. so, i'm disappointed with the administration's support for the waver but will continue to press for the consultations and robust analysis needed with such significant implications for health and national security. i'm going to ask two questions for the record and you can either answer now but if we run out of time, answer for the record. i have two questions. that are fairly simple and straight forward. the first is has hhs conducted any analysis of the impact of any waver of entelectual property on domestic manufacturing or innovation? the second question is has hhs conducted analysis of how long it will take foreign nations to manufacture and distribute covid
vaccines? and i'm not sure how much time i have left, but if secretary has time, he's more than welcome to answer. if not, i'll take them for the record. >> great to see you and i'll try to give you a response and i can follow up, if you like. let's recognize the president has said he's open to negotiations. there is no done deal. there has to be negotiations to see how textualy that will look. as someone who has worked in the past on issues involving intellectual property and our own rights as americans. we'll make sure we're protecting the property rights, as we always have in the wgo. whether we get to some negotiated language, that allows us to move forward, will depend on the negotiations that take
place on that trip's language. with regard to domestic manufacturing, i think there's bipartisan support to move in enhancing abilities to manufacture here at home. and the american rescue plan provided $10 million to increase domestic capacity. so, we worked with congress to make shur we have american manufacturers, whether it's masks, ppe, vaccines. >> thank you. thank you, mr. secretary. let us return to mr. doggett. you ready? okay. so, we'll come back to you again.
go ahead. >> thank you very much. i was asking the secretary about his reaction to allowing local governments to contract directly with cms as one way to neat gap of the uninsured. >> great to see you again and thank you for always pushing so hard on some of the matters. as the president has said we're going to do everything we can to expand access to care. thanks for the work you've been doing. you mentioned how states like california have taken advantage of the waver opportunities. what we want to do is say more americans are covered. we look forward to working with you to figure out a way to continue that growth. >> and is it important that our
legislation not discriminate, that we provide services for them? >> thank you for being dogged in this. we wanted to make sure everyone has a chance to participate and benefit from lower prices. >> thank you. let me now recinginize the gentleman from california to inquire. >> thank you plrks chairman. and thank you, mr. secretary, for joining us. good to see you in the ways and means space. i have two questions and then you can respond. i'd like to start by talking about telemedicine. i'm proud to have founded the bipartisan group and we're
working toinal sure high-quality services are available to all americans. and it was my bipartisan legislation that authorized mode care to expand telehealth for the duration of the pandemic. unfofrpinately they're going to expire once we get out of this public health emergency. and i've introduced anather piece of ledge slagsz that will insure patients can continue accessing telehealth services. so, my first question would be can you talk about how you view the next stoeps for telehealth and how does the administration envision incorporating telehealth into the program? and second, we have a huge number of plontal health
challenges in our country. substance abuse, suicide, depression, goes on and on. and we see the impact of these cries all around us. in the homeless population, prisons and jails, among our veteran population and among our teenagers. i've got legislation that would expand mental health services for seniors in medicare but it's going to take more than that. >> grade to see you again. and can't wait to visit your district. let me start with the second question first, if i may.
it will let us put money into mental health services and for substance use disorder services. major investments. never would have been possible without your support and we're going to put that to work immediately. secondly to the question about telehealth. do we get to learn things about covid-19, right? and now it's a matter of figuring out how we can deploy some of that long term. we look forward to working with you because some of the authority will have to come through statute and some we will do through administrative regulation. we have to take advantage of telehealth. >> well, thank you, mr. secretary. so many of the problems we face today are tied to mental health. you talk about homelessness and
idiction problems. you're going to turn to whatever you can for relief. and sadly, self medication with drugs and alcohol is often what folks turn to. we really need, in a bipartisan way to redouble our efforts to deal with the mental health challenge that faces our communities on a daily basis. thank you and i yield back. >> let me recognize the gentleman from florida. welcome back, mr. secretary. >> i want to tauch on the ability of add on. four years ago we were talking about bending the curve. there's a lot of people with little or no insurance. i want to talk about small businesses. and many have seen their costs go up 20% a year.
historically, i've shared first 20 years, paid everybody's insurance. the big corporations could afford to do that today. a lot of small businesses can't afford $14 a month. it gets pushed to the middle class, working folks and that's why they're so financially stressed out, borderline bankruptcy. i've seen it. so, how can we work together? there's probably 60 to 80 million people that are chipping in where many in the past didn't have to, out of their own pay. >> i was chairman of the florida
cham brp. a lot of them are working restaurants, small businesses. they can't afford to absorb all the increases. and i'm very concerned about many of them fine pangsally going bankrupt or they don't take the insurance because they don't afford the detuktability. what's your thoughts? >> great to see you and thank you for always championing the cause of small business men and women. you're right because so many don't have their own health insurance. we're hoping to make it more possible for people to be able tew ford it, have the choices. as i said 31 million are using the affordable care act.
in the special enrollment period pb initiated, we've seen so many take advantage. so many were for small businesses, wriltsz where it's tough to provide health care coverage. i am absolutely interested in working with you and others, especially if you're trying to get to the middle america, which often times gets squeezed and doesn't get the benefit from proposals out there. continue the growth of people in america who can get quality-affordable health care. >> appreciate. like to work with you and i want to keep those folks in mind. a lot of the people that are employees of small businesses, they're stressed out in terms of paying for their health care. looking back we used to pay everybody. now we're paying over havrlgs
bdss paying the other half. and i don't like it because it's money they can't afford to do. so, it's a big issue. i want you to give them consideration. in terms of your budget, you'ric lookingality a 23% increase. where are the majority of the dollars going to be focussed? everybody wants more spending but at some point, you have to pay for itself. >> so much of the money is going to be invested in. so much of what we're going to need tee do to recover from covoid and making sure small
business epial would fall out if we're table oo make this expanded support on the subsidy permanent. millions, who are in the middle, are going to be able to keep their insurance because they will no longer fall off the cliff when they get to a certain income level and lose those subsidies. much is invested to improve health care and make sure we tackle all the issues we're seeing as a result of covid. >> the gentleman from oregon is recognized to inquire. >> thank you, mr. chairman. and mr. secretary, it's such a pleasure to welcome you back to the committee.
it demonstrates his deep commitment. we face significant challenges, including the exhaustion of the trust fund. i'm pleased to see they would make significant adjustments in the insurance subsidies. however, making health care itself more affordable does not reduce the cost of health care itself. without changing the payment model, the cost will continue to increase, forcing us to spend more money on critical care. if we're going to be able to dole with long-standing capabilities that effect people of color.
it would be hard pressed for us to remain existing coverage without reducing the cost of care. it will be difficult to address medicare inflation through congressional action alone. the u.s. of 1115 and 1332 wavers, offers a path for a sarfully infected states that i pioneer said, if teaminal crease the total cost of care, from maintaining a access, quality, benefits. would you consider this the legislationive initiatives being pursued? >> as you know this administration is willing to look under any rock to see if
there's a better solution to health care. if you and your colleagues come up with good ideas on prescription drugs, better access, innovation, bending the curve, we're willing to listen. and i know you have a number of good idea said in your pocket. i'd love to continue to work with you on these things. at the end of the day, what president biden wants is to make sure americans don't have to worry about paying the rent or seeing the doctor. we look forward to working with you on that. >> i appreciate that very much and would look forward to exploring what has happened with the waver strategy as a way to deal with the total cost of care and i hope we could explore that together. one other thing, when we're dealing with the affordable care act. i was deeply concerned about end of life care and how we had problems.
we got them to invest in the end-of-life care. but there's very little utilization. any thoughts on what we might do to make sure they get the care they want in those vulnerable times? >> that's an issue near and dear to me because my father, who lived with me the last four years of life, had his family surrounding him before he died. you would think he had more say in their park. my state has made -- as your state has made advances, i look forward to seeing what we can do at the federal level.
>> let me recognize the gentleman from pennsylvania, mr. kelly too, inquire. >> thank you plrks chairman and mr. secretary, great to see you again. my big question in eery, pennsylvania, we hadnic of decisions and my question comes down to do we have any way we can look at what the contract is for people who are taking care of these children? it's a big operation. the kids in eery, pennsylvania, were only there a couple of days. after i was told they wouldn't be there at all because the facility wasn't reedy for them.
within two or three days nay were all gone. some had covid. could you please get back to you at the emergency intake sites. what is the contract? $800 per day per child. it's a huge operation. incredible job. we've been setting optent city to take care of these children. i would like to see, going forward, what is the policy going to be? what is the process going to be i know you're busy. i would really appreciate it. i don't expect you to answer this right now, okay. this is like jesus on holy thursday. you're getting it from all sides. if you can get back to me as soon as possible, i would appreciate it. i know people in eery didn't
understand it. they were very welcoming, by the way too, have these children there. they were there only a couple of days and then gauj. going forward, the policy, process, cost and what the contract looks like. >> great to see you. you still have the same energy. great to see, great to see. absolutely we will follow up. you're right the folks in eery were very welcoming. we have an obligation to make sure we take care of the kids and provide them with the safe and health that's required. let's follow up. what i can tell you is this. we take every effort to make sure we provide the safety and health needs of migrant children for however long they're going to be in the country.
we're going to do the right way. we've had a lot of folks come forward. >> if you could get back to me. good to see you. stay healthy. i'm really looking forward on this issue that we keep moving forward. thank you. >> let me recognize the gentleman from new jersey to inquire. >> good morning, mr. chairman, and mr. secretary. good to see you. you look healthy. stay healthy. i appreciate your work and the biden administration's efforts to invest in health care. many priority said in the budget, like strengthening the
aca, expanding medicare, they're long over due. the fda supports a unique device identification system. and we're finally, hopefully moving on it. that identification system references benefits and claims data. however, the cms budget customization makes no mention of this change. please describe the administration's plan to utilize the unique device identifier information being collected for medicare and medicaid programs and how the information will be
used for quality measurement. and will you encourage the adoption of new electronic claim standards under hipaa that include unique device information? >> first, great to see you. often times most people don't know about, get ignored but they're critical, especially when it comes to we're properly following the patient and making sure we have information on the unique device identifiers we mentioned. my understanding is, at this stage, right now they're before the national committee. called vital and health statistics. they're waiting to get the recommendation and move forward.
we can follow up as we wait to find out where that stands. as you mentioned, we have to make sure through the medicare claims that we can track these things. and that unique device identifier is one way to do that. >> it helps us in the examining. the device itself. you know better than i do. and these devices need oversight in terms oaf what they do to the human body. and we're finding more and more out and a lot of other companies don't like the idea. the second question was wall street's tentacles continue to grow. their control is associated with surprise billing, sky high nursing home death rates. you can't accept that.
all in the name of profit, not patience. so, ways and means oversight committee revealed, not that long ago a disturbing lack of transparency. we heard about the standards and quality of care. all my private equity firms. i like your take on it. >> what i'll tell you is i'm prepared to work with you. our obligation has to be for the residents, first and foremost and we have to have transparency and accountability. >> thank you. the gentleman from mr. reed is recognized to inquire. >> great to see you here at the committee. i want to get two quick
questions in. one is a very heavy concern about drug pricing and what the president has supported in the budget. one of the things i'm greatly concerned about is the quality of life years in setting drug prices from foreign countries in american drug pricing policy. i just wanted to see, secretary, if you could commit today to us, to this committee, that hhs will not use quality adjusted life years to set drug prices in the -- >> thank you and i love your office. the thing that technology lets us do right now. so, let me say you know we're going to do everything we can to bring down the cost of prescription medicines. we're going to look at everything.
but we will work with you and colleagues to make sure what we do is done right, that everyone feels it's fair and accountable. let me make sure we're in touch if you want to work on this issue. >> you had a conversation with my colleague on this issue. want to make sure quality adjusted light years does not become the defacto of your office and setting drug prices nationally, which i think would be a very difficult or problematic policy to establish in regards to the drug pricing policy. the other issue, and i have two minutes left, impacts our district. and that's the issue of crit krl hospital reimbursement policy. you know, i think, in your conformation testimony, that
there's a question of the mileage. i believe there's nine hospitals in new york state that have been impacted by the new mileage calculation, if you would. that hhs has been dealing with. and i want to get information from you. that they're defacto hospitals. and changing that policy from pre-2015 determinations to future determination is something i'm sensitive to and i know many colleagues oaf mine are sensitive to. what are your thoughts in regards to how we stand on that. can we get assurance in regards there reimbursement policy. >> i think one thing we found
with covid is some of our communities that are distant from providers need the support that makes it possible for all of us to get what we need. we want to make sure we're not making it more difficult or expensive for anyone. and so what i will do is -- you tell me when you want to follow up and i will because we have moneys in the budget that help us address the needs of rural communities. making sure they have an opportunity to survive. >> i got eight seconds. just on the mileage. if we could go to 2015. if you could get me that commitment today, i would luv that. >> i can certainly commit to work with you and see where we end up. >> you are a pro. thank you, mr. secretary. good to see you again. >> thank you.
and let me recognize the gentleman from wisconsin to inquire. >> it's so great to welcome back our friend and colleague. look forward to partnering with you right now in your new capacity. a couple of questions i have. i've been hearing from providers that provider relief fund money has to be spent by the end of the month. is there any consideration of extending the deadline, giving them more time and spending the provider relief funds that's been allocated? >> i feel like i'm in a family reunion but great to see you. and first,to the question. we're trying to provide flexibility. having watched how the provider relief fund was deployed, we're trying to make sure we don't make the mistakes of the past. we're trying to provide
flexibility. we can follow up but we want to -- we understand the need to have flexibility. so, soon, this month, we'll be coming out with guidance to help people make sure they can apply for and make use, good use of their moneys. >> i appreciate that. we'll follow up since we're a few weeks away from the deadline. and i'm going to be introducing bipartisan legislation with mr. kelly called the medicare advantage quality relief program. and it's incentive bonus payments for the plans getting their bench marks. the payment levels are based on pre-ac levels. just wanted to alert you we'll work with you to see if we can fix this problems to further incent the relief payments.
as you know w the lead up of the affordable care act, you and others were championing policy proposals that we could get into legislation. i hope that now going to alternative payment methods to emphasize quality, outcome, value. cmm wierks the alternative payment models. how committed are you in trying to move in that direction? >> you're music to my ears. cmmi was a product of the work done on the affordable care act. and another example of how president biden wants to taketic to the next level. if we see something stieting we go wait minute.
we don't have to keep it in the nih stream by itself. we can accelerate the opportunity to provide the public and health care. >> we knew it was more than extending quality, affordable accessible health care. it was also cost containment. and if there's more work to be done on that front. finally, as he emerged from the global pandemic is there any thought of doing a deeper dive on lessons learned out of the pandemic? things we did do well or didn't do well? >> no doubt. clearly we learned how much we could do at telehealth. we learned we have gaps. those communities that are in the corners, the shadows, still lack the ability to say equitably going to provide you with health care.
absolutely we're going to have a lot of lessons learned from covid. >> thank you, gentleman. let me recognize the gentleman from new jersey, mr. smith too, inquire. >> thank you, mr. chairman, mr. secretary, i want to start by thanking you to try to provide us with more insight into the president's budget request. before i jump into the request, while i have you here on april 21st, sen lee and i sent a letter 32 cdc director requesting cdc guidance for education. which i'm sure you know is the most strict in the world. evidence of lower transmission among children and the negative impact this guidance has on their daily live said. it is now over a month past the deadline and we've received no response. in light of the summer heat being upon us and reports of
some children being forced to wear masks in sweltering temperatures, i think american people urgently need to know the full picture on how the cdc arrived at its decision that children over two should be masks. mr. secretary, will you submit to insuring the cdc director provides a response to myself and the 31 other members of the house and senate who signed the letter by the end of this week? >> congressman smith, thank you for the question. it's an important one. i'll commit to you that any letter directed to the department, including the cdc, that you fet a response and we'll try to make sure we do it as quickly as you can. i can guy into the issue of masks, if you like but i don't know if you have other questions. >> the main thing is the response to the 31 one of us. mr. secretary, we still don't
know for sure if covid originated naturally or as a result of the virus being leaked from the wuhan institute. we do know that china is actively trying to hinder investigations into the virus's origin. and several prominent scientists, who might otherwise be in a position to help us determine the virus origin said, like dr. fauci are compromised. can you confirm funds in the budget. >> congressman, obviously this is something everyone's taken interest in.
i, myself, probably a mumgt ago, when i had an opportunity to address the world health assembly, i also said it's time for us to get 32 bottom of this. addressing pandemics in the future requires us to know the origins of the source. i can garnlt you we'll look for partners. and whether it's the authorities in the nhs, or others or the president himself working with the intelligence community to get to the bottom of this, we look forward to working with you on that. >> can you tell me if there are any funds in the budget that would be used to to aid foreign laboratories in the deadly, contagious pathogens? is there any dollars there? >> we have no dollar said dedicated or ear marked to do
anything of the sort. >> i appreciate it, mr. secretary. if we find china is blamed for the virus? will you commit to holding the chinese government responsible for this catastrophic accountant? accountability is something we're going to see from everyone, including the hhs. >> thank you. >> thank you, mr. chairman. and welcome, mr. secretary. i have serious concerned that social security and supplemental security income benefits that are being paid to foster youth are not getting to them. and are not even always being used for their benefit. so, mr. secretary, will you commit to working with my subcommittee and with social security to find a remedy to
this serious problem? >> first, may i say it's great to see you and thank you for always championing the cause for so many children that are underserved. i look forward to working with you. we're trying to do a better examination. we want to review the work being done on this particular issue. here we have to work with our state and local partners to administer these programs. but you're right we have to make sure these kids get the kind of care we would want to give to our kids. their voices included in this as well. >> thank you, mr. secretary. and many of the hospitals in my district, like loretta, suburban, mt. sinai, the new insight, are all struggling just
to keep their doors open because they serve this population group bilg time. where the money isn't really sufficient. i understand there are $24 billion unallocated in the provider relief fund. could you share with us plans to help these institutions that really need it right now. >> as you remember when i was here in congress, i worked hard with you and others to make sure the safety net hospitals that care for the sickest don't go under simply for trying to do the right thing. and have any dollars dispensed because they have proven it we're taking a close look at the
provider relief fund. we want to make sure we're transparent in how we do this. woit a doubt, we want to make sure safety net hospitals that were really there, helping some of the sickest americans with covid 19 get the support they need. we'll have transparency and accountability in how we disperse those dollars. >> let me recognize the gentleman from south carolina, mr. rice too, inquire. >> thank you, mr. chairman, and mr. secretary for being here today. your testimony you submitted, your written testimony, didn't mention telehealth. and i have three very rural counties with majority populations that are very much underserved in terms of health care facilities.
mental health has been a big boom. i'm glad to hear your testimony live where your support telehealth and want to give you one more chance. do you believe telehealth provides a valuable resource said, particularly for rural and minority areas? >> that's one of the easiest questions i've been asked today. the answer is yes. i hope your further questions will be just the same. >> i have a bill that would allow people with direct access to audioologists. they require, they have to get a referral is very ownerous to them. i think this is something you championed while you were in congress as well. will you support a change in the process to allow people to go
directly to audiologist? >> my role is a little different than my member of congress butted i look forward to working with you. we'll be there for technical assistance but we look forward to working with you. >> all right. south carolina is facing a reduction in their tanif lock grant because there's a requirement you have a 90% maternity establishment to qualify. the reason that we're not able to meet that threshold is because obviously the health care facilities and the laboratories were overwhelmed and we're just now coming out of it. but i don't know how quickly we're going to be able to and if we can't really afford to have our welfare recipient be docked.
would you supported a waver of the 90% establishment requirement? >> congressman, i don't know enough about this to be able to respond but i can assure you we'll get back to you and your staff to look into this further. the lens from which i look at this is how are we providing accountability and equity and, at the same time, in a transparent manner, so everyone understands how hhs has moved forward. >> this would effect the poorest of the poor and it's not their fault and it's not south carolina's fault we had covid and facility said were overwhelmed. one more question. i notice your budget includes a 6.5% increase in medicare spending, medicare trust fund is
slated to go insolvent as soon as 2024. how do you propose to makeup the difference in the medicare trust fund? was your plan? we've got to make this medicare program golden. we've got to make it concrete for our seniors. how can we afford to spend more when we're already going to be insolvent in just three years? >> we're going to do what we can. i can follow up with you on that, congressman. i know time has expired. >> thank you. >> thank you. let me recognize the gentle lady from california, mrs. sanchez too, inquire. >> thank you, chairman. before i get to questions i want to note how surpriseing it is that my colleagues on the other side of the aisle have mysteriously become concerned about unaccompanied minors in hhs custody because they didn't
seem concerned under the last administration when accompanied children were taken from their parents or were forced to stay in squalled camps on the mexican side of the border because they were prohibited from entering the u.s. i find interesting that suddenly there is a concern for their well-being and i wonder why it took so long for my claegs on the other side of the aisle to notice or even care what happens to these children. i'm going to leave my could you are i don't sayity there. i couldn't leave that alone without commenting. secretary becerra, the president's budget provides long, overdue investments to help american families get back on their feet. and the budget includes funding for important democratic priorities that i have proudly supported for many years. federal help to make health insurance more affordable, access to child and eldercare, and many other things. but, let's be clear, these investments are, you know, a critical first step as our nation rebuilds and recovers from the pandemic. the covid-19 pandemic exposed
various ways in which our health system isn't really working and we must follow these investments with actions to address the gaps that we've become aware of. for example, the pandemic showed that nursing home facilities were dangerously unprepared to protect the health of residents in their care. according to the kaiser family foundation, on average, long-term care facilities account for 5% of covid cases, but over 30% of all covid deaths in the u.s. the previous administration advanced many proposals that have allowed nursing homes to steer clear of accountability at the expense of residents and their families. predispute binding arbitration agreements are just one example. i think that this is tragic. i've been working for many years with the american association for justice and aarp to try to correct this. and just in april congresswoman shikowski and i asked to rescind
the trump-era rule of these harmful use of these binding arbitration agreements. mr. secretary, president biden's budget recognizes the need to provide oversight of nursing home. are you considering additional measures to empower nursing residents and their families to exercise their legal rights or to hold nursing facilities accountable for their actions when they fall short of the standard of care? and will you commit to rescind some of the most damaging trump policies to better protect our nursing home residents? >> congresswoman, thank you for your passion on this issue. and we look forward to working with you. one of the areas that i concentrate quite a bit while i was attorney general was this area as well, making sure we did better oversight and enforcement. we intend to do the same thing. we look forward to working with you. our first obligation in these facilities has to be the patients and we have to do a
better job of having these facilities be traps patient and collecting the data that helps us understand what's going on. and so we will look forward to working with you. as i mentioned in my opening testimony, we are going to do everything we can to hold people accountable. and that means that we're going to do a lot of integrity work to make sure that what is out there and what we fund with taxpayer dollars has the eyes of the american public on top of it. >> thank you, mr. secretary. and just really quickly, the president's budget includes robust funding for alzheimer's research diagnosis and care. but one of the best ways to sort of set a base line to track this disease early is through the medicare annual wellness visit. so, i'm curious to know if what you are doing within hhs and cms to strengthen early detection requirements in the annual wellness visit? and i've run out of time so i'll take that answer in writing. and i thank you for your presence today. >> thank you.
>> i thank the gentlelady. let me recognize the gentleman from arizona, mr. schweichert to inquire. >> thank you, mr. chairman. mr. secretary, first, this is my moment to also thank mr. thompson for his sort of dogged focus on telehealth, and it worked. we did something amusing a couple weeks ago. we looked at the previous couple years of memos and those things about telemedicine and how skeptical many of our staff and brothers and sisters were now that we've lived through it, and we realized what a plus it was. i desperately hope you'll join us in getting it so it's extended, it just doesn't come to an end, the expansion once the pandemic is declared over. and, mr. secretary, one other thing. and this is sort of the big picture. both in reading your budget over
the weekend but just even our own conversation we're having today, main many of us talk about health care and affordability in a light of who gets subsidized, who does not get subsidized instead of what we pay. and i will beg of you, start thinking about what we pay. because over the next 30 years, the hundred plus trillion dollars of u.s. sovereign debt that will be on the books in today's dollars, 67% of that is just from medicare. we need a revolution in what we pay. and something like diabetes is believed to be about 30% of that. i notice your budget, the president's budget, does have a fairly substantial plus up in spending for diabetes research. i believe you would find many of us on the republican side are willing to step up and propose almost an "operation warp speed"
to disrupt and finally take on diabetes. because if you look at health outcomes in rural america and urban america and you actually put the charts of bad outcomes from covid and you line them up also with the charts from diabetes, you'll find that comorbidity, in many ways, is responsible for much of the deferential and health outcomes. those are my pitches to you, mr. secretary. what do you have to say? >> congressman, i think wise words with regard to diabetes. and we should heed the call to try to do a better job of addressing some of these chronic illnesses that lead to death so quickly. and i agree, covid exposed what we knew about diabetes, that it can kill, and it can kill quickly. can i just say on telehealth? absolutely agree that we're going to move forward with what we learned from covid. i'll add two words. access. because you have to make sure everyone has access, not just
some parts of the country, not just some rural areas. but you have to make sure that broadband extends everywhere so everyone has access. and the second thing is accountability. as we let folks do provide care further and further from the source, we just want to make sure it's accountable because taxpayer money, whether it is medicare or medicaid, is in there and we have to make sure we're getting the value for our dollar. >> mr. secretary, i encourage you and your staff to look at one or two things. one, every inch of north america now has broadband. it's called low-earth satellites. being from arizona, as you would know being from the west, my rural, my native american populations in the middle of nowhere where it would be irrational to run a line of fiber or copper. now with a small satellite dish, they have broadband. we need to start thinking in terms of this century. the second thing is the ability to audit, monitor telehealth.
and telehealth is more than facetime with a doctor. telehealth is also the sensors i can wear on my body that monitor and help us keep healthy. i believe we could crash the cost of healthcare if we're willing to be disruptive with technology. thank you, mr. chairman. >> i thank the gentleman. let me recognize the gentleman from new york, mr. higgins, to inquire. >> thank you, mr. chairman, secretary, thank you for being here. i just want to recognize how far we've come in the past 15 months. last year at this time the united states was the world leader in covid-19 deaths. today we're the world leader in vaccination distribution and administration. 42% of americans are fully vaccinated. that is an incredible, incredible accomplishment over a very short period of time. the science for these vaccines
came from scientists within the national institutes of health and in the biomedical advance research development authority, mr. secretary, that comes under your jurisdiction. again, incredible an incredible accomplishment. the messenger rna is the stuff that converts dna to proteins. proteins are the active ingredient in the vaccines. moderna stock is up 10% today, one of the manufacturers of the vaccine. moderna's pre-covid share price was $21 a share. today it's $209 a share. moderna precovid was valued at about $6 billion. today they're valued at $32 billion and projected to be $100 billion company within the next 48 months.
there is a 1980s law that keeps the government from sharing in the commercial success of the taxpayer-funded research that made these vaccines possible. and my question is, you know, given the united states government's investment of $11.5 billion into vaccine development, in all of the years of research that predated the actual manufacturing of them, don't you think it's time that the u.s. taxpayer share in some way beyond the public good that it does but share in the financial success that would not have been possible without the research, which is very expensive and not profitable, financed by the american taxpayers? >> congressman, first, good to see you. always good to see you.
second, you ask a really telling question. and it's one that i think in less five minutes we won't be able to answer. but taxpayers made it possible for us to have a life-saving vaccine. and i think, one, it speaks to the innovation and the prowess of america. two, it also speaks to our generosity. but, three, it also speaks to where we need to go. u.s. policymaker miaz to make sure that we're ready for the next pandemic, we're ready to provide the next generation of medicines. i am more than willing to engage that conversation because we're going to count on our taxpayers to help make us work. at the same time our taxpayers expect us to be accountable so that they know it's worth an investment, they have the confidence to continue to pay their taxes and make the kind of investments that have made america so strong. i look forward to having that conversation. but you pose a really important question.
>> and finally, mr. secretary, i represent communities along the u.s./canadian border. and we need to get more vaccines into canada so that we can get that u.s./canadian border open. it doesn't require a comment from you, but i just want to make very clear every time i get the opportunity to talk to somebody from the administration i have to convey that message. so thank you very much, sir. >> thank you. i would just add that i just recently had conversations with their health minister on these subjects. so we look forward to working with you. >> i thank the gentleman. let me recognize the gentlelady from indiana to inquire. >> thank you, mr. chairman. and thank you, secretary becerra, for joining us today. right now i'm very concerned with president biden's border crisis and the surge of unaccompanied minors that we've heard about today, unaccompanied migrant children and it has overwhelmed the border patrol and other federal agencies. the current humanitarian crisis at our border could've been avoided if the biden
administration hadn't undone years of work from the trump administration to establish robust enforcement mechanisms, closed regulatory loopholes, secure agreements with mexico and central american countries and constructed vital security infrastructure like the border wall. the previous administration's approach was an innovative and well-coordinated effort between federal foreign agencies and foreign governments. mr. chairman, i'd like to ask unanimous consent to enter into the record an article from the national review entitled how trump got control of the border. in contrast, the current administration has rejected these common sense policies which were clearly working. not surprisingly, the result is a crisis that far surpasses is you anything we ever saw under president obama and trump. the biden administration has a responsibility to acknowledge that what we are seeing at the southern border is indeed a crisis, and that its misguided policies are to blame. the biden administration also has a duty to address the downstream effects of the border crisis. we've seen news reports from
washington and texas about youth being displaced and forced to vacate their residence in order to make room for unaccompanied migrant children. this is extremely alarming especially given the already limited available more permanent placements for foster children. mr. secretary, what's the extent to which the surge of unaccompanied minors at the border has impacted or burdened the capacity of state child welfare agencies to place foster children? and then as a follow-up, has any child in foster care in a not-for-profit or community-based organization been displaced by hhs contracts to house unaccompanied minors? >> thank you for the question. and let me, as i said to congressman brady, assure you that we take every step necessary at hhs to make sure that the work we do with the unaccompanied migrant children does not impact the ability of the domestic foster care system to care for our children who need that foster care service. we have done a tremendous amount
of work to try to make sure that at the same time at the border we are relieving the customs and border protection service from the need to try to care in our adult detention facilities for children. we've been able to place those kids in our custody and keep them safe and healthy the way the law requires us to. >> mr. secretary, would you agree that it's important for hhs and fda to require rigorous reporting on drugs developed specifically for women so we can clearly understand potential risks or complications to women? >> we certainly want to make sure that we follow the science. and i think fda tries to do that as best it can. and we are always going to try to make sure that we put out the type of medicine that has been proven to be safe and effective. and that includes whether it's for women or for men. we want to make sure that what we can do is make sure that americans can trust our healthcare system. >> thanks. and i think we should prioritize better data collection on the
chemical abortion pill prifamestone. in addition to killing an unborn child this drug can cause heavy bleeding and serious infections in women. and as of 2016 providers of this drug are only required to report patient deaths but not to report hospitalization, transfusion, or any other serious events. will you commit to prioritizing better data collection for this drug so we'll have a clear picture of the potential risks it poses to women? >> congresswoman, as you know, when the fda acts, when hhs takes action involving prescription medication, we follow the science. certainly we'll make sure that everyone is accountable. because we have to ensure the public has confidence in the system. >> i thank the gentlelady. let me recognize the gentlelady from alabama to inquire. >> thank you, mr. chairman. i'd like to thank you and secretary becerra.
welcome him back to this committee as a longtime member of this committee. secretary becerra, it's great to see you. i am encouraged that president biden's budget invests in healthcare and the economy and aims to improve the health of all americans, especially by addressing the needs of seniors and people with disabilities and expanding access to the aca healthcare tax credits and medicare benefits. however, the pandemic has laid bare the historic racial inequities that exist in our healthcare system for so many americans. my constituency in the black belt of alabama is aware of the pervasive, systemic, and institutional influence that have influenced and contributed to the disparities in healthcare. as is true in so many areas of healthcare, a lot of the problems center around access to care, and trust in the medical and scientific community. a specific area that i'd like to focus on today is cancer. a disease that takes over
600,000 american lives every year, and one that minority and rural populations are especially burdened by due to the higher rates of late-stage diagnosis. experts tell us that one of the most important ways to beat cancer is to catch it early before it spreads. if you or your loved one is diagnosed with cancer, the very next word that you want to hear is, but we've caught it early enough. i have sponsored last congress and this congress a bipartisan bill called the medicare multiple cancer early detection screening coverage act, a bill that i am pleased to be co-sponsoring with colleagues representative errington, rouz and hudson. this legislation seeks to modernize medicare coverage to enable providers and seniors to have access to new tests that use a simple blood draw to screen for over 50 types of cancer, including pancreatic
cancer and find them early when patients still have a fighting chance. but until now, our tools to do so have been limited, secretary becerra. we only have screening for five cancers that are covered by medicare. and for this reason pancreatic cancer and so many other cancers are not being found early enough. and the impact on seniors and medicare in terms of cost is staggering. catching cancer at its earliest stage in people without symptoms would be an amazing game-changer. currently unknown cancers continue to spread often becoming metastatic and lives are lost because of that. pancreatic cancer, has a very low survival rate, in part, because it is not caught early enough. only 80% of the cases that present with this disease have a survival rate. only 15% of pancreatic cancers
are found early enough. and survival rates for pancreatic cancer are six times higher when it is found earlier versus late. in fact, this very committee, your colleague, our friend congressman john lewis passed away because of this cancer. fortunately, a new multicancer early detention screening tools are emerging for our seniors and medicare patients who are often most at risk. i ask for your commitment, secretary becerra, in addressing this horrible cancer, all of these cancers by expanding the access to tools in the toolkit that will be paid for by medicare that we can catch this disease early on. in closing i'd like to ask a question regarding that, sir. i know that you're committed to closing the equity gaps that exist in healthcare. can you talk to us specifically about what this administration is doing about that and how we can work with you in order to make sure we're saving lives?
>> mr. chairman, why don't i respond back to congressman -- >> give a brief response, mr. secretary. that would be fine. >> very briefly and we can always follow up, congresswoman. first, preventive care, that was the whole process behind the affordable care act is to get to people before they were too sick. we know for many communities, especially rural and racial communities, we are always at the end of the stage when it comes to getting good care up front. second, get good data. we have to reach those corners of america that are left behind. we can follow up, mr. chairman. >> thank the gentlelady. let me recognize the gentleman from ohio, dr. winstrom, to inquire. >> thank you, mr. secretary. it's a pleasure to be with you today. health care -- i'm a physician. healthcare is and should be a national priority. i'm encouraged to hear you talk about finding the origins of covid, identifying that i served
on our board of health in cincinnati. and you're exactly right, we can't address these types of issues if we don't get to the bottom. going to the border quickly. when i visited there back in april, we saw many coming in with lice, scabies, meningitis, chickenpox, flu, and of course covid-19. and i think this is a very serious concern that we have for the health of america when this is coming in. so i do want to work with you. i'm encouraged by your concern. but let's work towards a healthy immigration policy that is best for everyone. i want to go next to drug pricing. we need to address the cost of drugs in the united states. it's important for our patients. and i think there is bipartisan room here. and i believe that foreign price controls will not leave room for the next set of cures. and so we have that balance between innovation and then cost at the end of the day.
let's lead the world on both of those things. i know there's a lot of things we can work together on. i always talk about the health span of america. you kind of touched on it there a little bit. we always take a look at lifespan, but what about the health span of americans, prevention and cures are often looked at as a cost. and that's on the short term, but we don't often look at what we save in the long term when we do this. it sounds like you are on board with that. i do want you to be aware that we have rural and underserved healthcare task force that the chairman put together. and it includes representative arrington, sul, davis and me. and i look forward to working with you to address the health disparities in these communities. you sound eager to want to engage in those. so i appreciate that. substance abuse, we can't ignore that. it's a problem if you've read the book "dreamland," that's my district on the cover. if you haven't read it, i recommend it to your attention.
i am proud of the work we've done on surprise billing. let's make sure it gets done right. and i will say this, too, as a physician there's no part of me that doesn't want americans to have access to healthcare. it's obviously extremely important. we talk about medicaid. i'm proud to live in a country that has a safety net like that, that is there for people so that we can maintain some health for those that have trouble affording it, and for other reasons. but the statistics have showed that that particular plan has the highest mortality and morbidity of any in the country. i think we're better if we start to look at solutions to how fewer americans need the medicaid program. because the fewer that are on it, then the better for those that are still in it. we want more of the best care for more americans. so i'd like to continue to work with you on those issues. so, i threw out a lot there. but i really do look forward to working with you. and i'm asking you one question.
will you commit to work with congress, and in particular members of congress that have medical backgrounds? we met many times. our doctors caucus, we met many times with secretary azar. it was very productive. and i think we can do the same with you. i'm hoping that as you work through payment rules and other issues that impact our healthcare providers, and more so our patients, that you'd be able to spend some time with us as we have boots on the ground, so to speak. >> congressman, you put a lot out there. but i certainly am looking forward to working with you and working with you from the vantage point of a physician, your experiences are going to be immensely important and helpful to us. so absolutely look forward to working with you and your colleagues. >> thank you so much. >> thank the gentleman. consistent with community practice, we will now move to a two-to-one questioning ratio beginning with the gentlelady from washington. >> thank you, mr. chairman. and thank you so much,
mr. secretary, for being with us. it's great to see you. and thank you for the work that you and your staff have been doing already on so many important issues and for preparing this very forward-looking budget proposal. i'm particularly pleased by the inclusion of kidney x. kidney x is a public/private partnership that was established to accelerate innovation in the prevention, diagnosis, and treatment of kidney diseases. more than 37 million americans are living with kidney diseases. and nearly 800,000 suffer from kidney failure, which is an incurable disease, which requires dialysis every few days to stay alive. and it's only cured by a kidney transplant. kidney disease can be extremely debilitating, causing patients to leave the workforce or die prematurely, and the cost to medicare is substantial. nearly a quarter of all traditional medicare spending is on kidney disease management.
but, sadly, kidney disease disproportionately affects communities of color, black americans comprise 13% of the u.s. population but represent 33% of americans living on dialysis, which is just one striking example of the health disparities in our country. and since roughly half of all patients who are hospitalized from covid-19 suffered kidney damage, we can expect these figures to worsen. when kidney x was conceived, there was an expectation of $125 million from the private sector and $125 million from the federal government. and given the remarkable success of this public/private partnership in its first two years running for prize competitions in which innovators in 44 congressional districts tackled longunmet kidney patient needs and made long inroads to an artificial kidney.
the private sector, which has been led by the american society of nephrology has already committed matching funds of $25 million annually to kidney x. i hope we can count on you and the administration to help match that commitment. >> congresswoman, great to see you. and i know in our budget we do include some funding for the kidney innovation accelerator. i don't have the map. we can try to get that to you later. but we do make a commitment to continue kidney x because you just mentioned the reasons. it's so important that we try to address these types of conditions as quickly and early as possible. and, as you mentioned, often times disproportionately this impacts communities of color. we very much look forward to working with you on this. when i have a chance to visit your great state, maybe run into your husband kurt again as i did the other day, we'll have opportunities to discuss any number of these issues. >> thank you. also, everyone knows that we
have so many areas of healthcare policy where there are opportunities to do better. and one key area is prior authorization in medicare advantage. i partnered with congressman kelly. we have garnered overwhelming bipartisan support to make prior authorization fully electronic and streamlined. patients need care right away. this is critically important that we have a system that works. and also i look forward to working with you to help us improve prior authorization for our providers and our seniors who right now face unnecessary delays in care. so i look forward to working with you on that as well. >> i absolutely look forward to working with you. >> thank you, mr. secretary. i yield back, mr. chairman. >> thank the gentlelady. let me recognize the gentlelady from california, ms. chu, to inquire. >> secretary becerra, it's so wonderful to have you back with the committee today, and always a pleasure to see a fellow
southern californian. as california's attorney general, you led an amicus brief to defend the human rights of children in immigration detention as established by the flores settlement agreement. after visiting one of these unlicensed facilities in 2019 put together under the last administration, i was horrified and introduced the shutdown child prison camps act to ensure no federal money would be allocated to emergency influx shelters that don't comply with flores standard which prevent children from being held in inhumane conditions. how will you ensure all policies related to the care and custody of unaccompanied minors are compliant with these standards and that these standards are the minimum to which children will be treated by your department? >> congressman, thank you for your work on this. great to see you, and to continue to work with you now in this position. i think if you've had a chance to visit some of the sites that we have stood up, you'll see that not only do we care about
following the law, but we treat these kids as what they are, children. and we're going to provide them with the health and safety that is expected. it is not easy, it is a challenge, it is not inexpensive. but i believe we have an obligation to do it right. you know there are a couple of sites there local to you in long beach and in pomona. if you have a chance to see those sites, you'll see something very, very interesting. in long beach we were told, this is about a month ago when i was there, some 70,000 toys and gifts had been donated by folks in the community in southern california for these kids. obviously we don't have 70,000 kids in the long beach site. that made it possible for us to be able to send some of those new toys, new books to other children throughout the country where we have these sites. i think we look at this very importantly as something that we need to do because these are kids. >> thank you. and i did visit the pomona site. it was very, very impressive and
so different from the last administrations. secretary becerra, thank you, and for president biden for offering a budget without the harmful and discriminatory hyde amendment. i also want to thank for highlighting the importance of the title x family planning program in your testimony. after years of president trump's harmful domestic gag rule, i believe we have to swiftly implement the new biden administration rule once finalized to bring providers back into the program and provide quality family planning care to their patients. can you discuss how you plan to rebuild this program as soon as possible, including by administering the additional funding that congress provided title x providers in the american rescue plan? how can we and congress be helpful to ensure that more low-income americans have access to this vital and successful program? >> congresswoman, as you know, title x is one of the crucial programs to make sure that we
provide access to many families that otherwise would go without it. and so we intend to try to move as quickly as we can to provide access to family planning services, which, by the way, are not just services for women. men, children receive services through the title x funding that's provided at the federal level. in california, as you know, we rely on a lot of our third parties to help make those programs work. what we're going to do is work as closely as we can to make sure that according to the law we're providing services under title x to anyone who needs those family planning services up front. >> thank you. and let me just say a word for disaggregation of data for asian pacific islanders. at the beginning of the pandemic api's were lumped into the other category on the cdc website. that prevented us from knowing very crucial information. so i just urge you to continue to disaggregate data.
>> i thank the gentlelady. let me recognize the gentleman from nebraska, mr. smith, to inquire. >> thank you, mr. chairman and secretary for your appearance here today. i do want to kind of reflect on how the c.a.r.e.s. act came about at the beginning of the pandemic, done on a very bipartisan basis and "operation warp speed" was done on a bipartisan basis. and i'll be very direct. i'm concerned that things are being done without the spirit of negotiation and compromise. more specifically, i want to talk about the cmmi, center for medicare and medicaid innovation. and my underlying concern is that providers and patients aren't able to give the feedback -- or for feedback to be received. perhaps it can be given, i'm not
sure it is being as received as i think it can and should be. we've worked on a bipartisan basis on the committee here and beyond to move this forward in a way that can really move us toward value-based healthcare that i think is supported on both sides, or shall we say on all sides. the alternative payment models, there's concern that the election stood in the way there and now things are being disregarded. and, overall, we're just kind of the alternative payment model situation is getting set aside, is my fear. so i was wondering if you had an update on that, cmmi in general, even of where you think we are
headed there and where we might be able to work together. >> congressman, thank you for the question. cmmi, quite honestly, i think cmmi is at the cutting edge and lets us know how to deal with healthcare moving forward not only in terms of better health but better costs when it comes to healthcare. if there are some questions or any comments or concerns that folks want to raise, i hope they will, because cmi is a small shop, but it does really important work. and i hope what we can say is that we're proceeding on a bipartisan basis when it comes to the work of innovation because no one has the corners in market when it comes to innovation. there are a whole bunch of innovators out there who could care less what our politics are. i look forward to working with you on that. i think president biden has made it very clear, in fact, as he's talking about negotiating on the american jobs and american
family plans, he's trying to see where we can work something out to move forward with infrastructure and investments. but i look forward to working with you and all of your colleagues on both sides of the aisle, especially on something like cmmi because i think we can both agree that cmmi is one of those incubators or good ideas. >> yeah. well, i appreciate that. on another brief topic here, telehealth. we have some telehealth measures that are due to expire at the end of the pandemic. i was wondering if you could touch briefly or just acknowledge perhaps a desire to utilize telehealth more or at least continue what we have been able to achieve throughout the pandemic. this is an issue that i worked on even before the, you know, representing a very rural constituency. and obviously we have reasons more than rural now to utilize telehealth. so i was wondering if you could
reflect briefly on telehealth. >> you might want to unmute, i think. looks like you're muted. >> secretary, it looks like you're muted. >> there we go. >> okay. here we go, i apologize. [ inaudible ]. >> we will do everything we can to try to implement some of the things we've learned -- covid. are you getting the echo i'm receiving? >> i do hear some feedback.
but i think you're better. go ahead. >> well, we look forward to working with you on that because that's crucial. telehealth has proven itself a true value. we just have to make sure that we can provide it equitably and that we have accountability in its use so that we can assure the american public that the money is being well used. >> you bet. thank you very much. i yield back. >> thank you. let me recognize the gentlelady from wisconsin to inquire. >> thank you so much, mr. chairman and ranking member, all of my fellow colleagues on the ways and means committee. mr. secretary, i predicted that we'd be back here. just can't lay in the sun and on the beach forever. and at a time like this, you are really, really needed. welcome back to washington. so many questions, so little time. let me just say that i gave up years of seniority to get on this committee, primarily to deal with the problem of a permanent underclass that we've
created comprising mostly women who are under the tanf program. and the minute they earn two cents over the minimum wage, they lose childcare, they lose health. they are the primary employees in a low-wage economy of restaurant workers, $2.18 an hour, healthcare workers, just cnas and so on. and, so, you have committed a billion dollars towards an emergency relief for this group of folk, and then another $100 million to make sure that people of color are not overrepresented in welfare programs. so, number one, i am curious about how that money is being spent. and, secondly, i'm curious about what have we learned in terms of time limits, in terms of
requiring people time limits in a counter cyclical economy. and that my informer says we reauthorize or end welfare as we know it. and sort of going out of the door question, where is the beef? i am so happy to see that the administration has committed $400 million to the problems of maternal morbidity and maternal fatalities. but i am wondering -- i am hoping to work with you to make sure that there is some meat on these bones. i have a proposal. we have the momnibus, but i also have a proposal mamas first to make sure that medicaid pays for dulas and midwives and people who are really expanding the healthcare work force to prevent some of these deaths.
also signed into law under the former administration is the scarlet sunshine or sudden unexpected death. leading cause of infant death, but i want to work with you to make sure we actually fund it now that it's law. it would provide research and best practices on how to prevent the so-called sids death. so i will yield to you for your response, mr. secretary. >> congresswoman, great to be with you. i will say to you two things. one, we need to help those who are in most need. whether it's the fund that was made available for those tanf recipients, we're going to try to do the best we can to make sure that they recover from covid as best possible. we look forward to working with you because most of those funds still have to be drawed down. on the second issue on maternal mortality and morbidity, you know this well.
it is communities of color that suffer the most, including in the black community where you see this really impacting so many women. we have done what we can to try to make it clear, states should sign on to help us. one of the things that we've done is provided through the medicaid program that allows women to receive postpartum care for more than just 60 days, for a full year. so we hope that they'll take advantage of that. >> i thank the gentlelady. let me recognize the gentleman from michigan, mr. kildee to inquire. >> thank you, mr. chairman, and mr. secretary. it's always good to see you. i never had the chance to serve with you on this committee, but we serve together, and i'm happy to see my friend. also, i'm really pleased to see the new hhs initiative, the low-income housing water
assistance program, which will make funding available to help low-income families afford something as simple as their water bill. as you know, i've been advocating for a program like this for many years. you were right there with me fighting for the people of my hometown when it was in a water crisis. access to clean drinking water is, fundamentally, a basic human right. some of the poorest communities in america pay the highest water rates. for example, just a few years ago it was found that on average residents in my hometown of flint paid almost $900 a year for water service. many paying more than a thousand dollars a year. many several hundred dollars a month. a lot of communities facing systemic issues, job loss, population loss, failing infrastructure, but had increased water rates shifting the burden, again, to some of the poorest ratepayers in the country. and so i commend the hhs for moving forward on this important
effort. and i'm just curious if you can share with us either now or in writing what hhs is doing to make sure that funding will be made available as soon as possible. -- saginaw, bay city, but also other places around the country where this is a really serious issue. >> congressman, very pleased to see you, and waiting for you to take that seat behind you in front of those drums. [ laughter ] maybe later. what i will tell you is that we have -- i believe the initial round of funding has gone out last week about $160 million. there is over a billion dollars that will be made available. but, without a doubt, the sooner we can get this out, the more people, more families we're going to help save. thank you for the work that you've always been so actively behind. and we look forward to partnering with you on this. >> i appreciate that very much. i mean, we know especially
during the pandemic when people were being continually reminded to wash their hands, and very often the poorest people were having to make a decision about whether they were going to turn that tap on, knowing that the bill is just going to run. we have a real problem in this country where we have real disparate cost structures for something as fundamental as drinking water. so this program i think really has an opportunity to help correct some of that. it won't be until we make the big infrastructure investments that allow some of those places that are structurally unsound have water systems that are structurally unsound to correct some of those deficiencies and have a water delivery system that is more affordable long term. but, in the meantime, this program is really an important intervention. and i appreciate your work on it. with that i say thank you, great to see you. i hope to see you in person sometime soon. with that, mr. chairman, i yield
back the balance of my time. >> let me recognize the gentleman from texas, mr. errington to inquire. >> thank you, mr. chairman, and mr. secretary, congrats on your appointment. and thank you for your service to our country. i will look high and low for a common ground. and i always think it's best when we can work together in a bipartisan fashion. i'm honored that the chairman and ranking member have entrusted me to serve on the health care -- rural health care task force for ways and means. we've done a lot of good work on payment system reform and telehealth application to improve access in rural communities. there's much more to do, and i look forward to working with you on that specifically. we all have desired goals that i think we agree upon with respect to healthcare policies in getting these incentives right, namely, to improve access and quality and to lower the cost. i would say that obamacare was
an abject failure on every front in that regard. i mean, it doubled the cost of care, people literally millions paid a fine to get out of the program. and the ones that stayed in it had very little choice. and so i think doubling down on the experiment on government-controlled healthcare is a real disaster exponentially. and i do think it also expanding or making permanent the temporary waivers is a problem, especially when you take away the percentage of poverty level and below whereby people receive subsidized care. so now people making millions can get subsidized care. i think that's wrongheaded and irresponsible. i think that the mention of climate crisis is always intriguing to me. i think we all just -- i have a different opinion and definition of crisis. i do believe in stewarding the
environment for sure. but i think if you ask seniors, for example, if they thought the climate change was their crisis or in five years medicare being insolvent was a crisis, i'd say the latter scares them a whole lot more. and i see no plan to fix it. i see only an acceleration of the insolvency by expanding medicare to 60 to 65. on the topic of crisis, i know i haven't heard a lot of admission that there's a crisis at the border and the administration, and i'm not trying to play a gotcha here, but if you go to the texas border, you will find out that there is just absolute chaos, and there are threats to americans on many fronts, not the least of which is the spread of covid coming across the border. this administration kept title 42, for which i'm grateful. but it only partially implements it. that is, it differentiates
between a single adult and a child or somebody that's part of a family. they're all hosts. they all create a threat of bringing covid spreading it, inundating our system and having a surge that could not only put us in a bad way but could actually kill american people. so, mr. secretary, would you address title 42 and why that differentiation and why not just fully enforce it during this pandemic and recovery? and i yield all the rest of the time to you. and i thank you again for your service for our country. >> congressman, thank you for the question. what i can tell you is that title 42 is based on the actions by cdc based on the science. and so the administration moves on title 42 based on the recommendations made by cdc. the implementation then impacts not just hhs but department of homeland security and others. what i can say to you is that we use the best judgment we can
based on the science to take action. i can try to respond further in the future. >> thank you. >> thank the gentleman. let me recognize the gentleman from pennsylvania, mr. boyle, to inquire. >> thank you mr. chairman. and it's great to see you again, mr. secretary. seven years ago when i first won literally the very first call that i received from a future colleague was from xavier becerra. so you have been a good friend to me and my family ever since. in just the few minutes available, i wanted to try to quickly highlight two areas. the first is just a statement. i was very excited to see in this budget a commitment to expanding medicare in dental, vision, and hearing. in my view and the view of many of my house colleagues, that is a real missing gap in our current medicare system. so one of the many things i'm excited about with this budget proposal is the commitment to
expansion there, building upon the work that many of us have done on this side of the aisle. but let me shift gears to something different and try to -- i know you've talked about it already, but try to get further comments on. i am very alarmed about the dramatic spike we've seen in mental health issues and substance abuse over the last year and few months. governments, the 50 state governments and various municipalities and the federal government had to take dramatic action to try to best fight the pandemic, even despite those efforts this is the third deadliest event in american history. but one of the many downsides of the actions that we had to take is the spike that we've seen, for example, a 30% year-over-year increase in substance abuse deaths, overdose deaths. not to mention the dramatic rise in mental health issues.
i've seen it in my own community and among people i know. so i was wondering, you know, not just for this budget but if you were to take a step back, what you think we could do together to attempt to address these two twin but related crises. >> congressman, good to see you first. secondly, i hope that we can work together on this on a bipartisan basis. i will say to you that we've begun. a week or so ago, i announced that we were releasing $3 billion to help local governments, states, and our community partners address both mental health and substance use disorders in our communities. and we hope that we can supplement that with your help through the american family plan to make sure that we take this on. we really do need to get to the point where we treat mental health the same way we treat
physical health in terms of insurance and coverage. so i'm looking forward to working with you on this because it's time, covid-19 has exposed the deficiencies we have in our system. >> just building off what you said very quickly, mr. secretary, covid-19 didn't create these problems, but, boy, it has helped expose what already existed and then exacerbated those issues. unfortunately, some of our friends out there in the private industry, as much as we attempt to pass legislation mandating parity, we still see time and again where in practice it is just not being carried out the same way. finally, i would say one of the few bright spots out of the 2016 presidential election was a real, for the first time in my lifetime, focus on the opioid addiction and overdose issue. i would point out to everyone overdoses were worse last year than even back four, five years
ago when it was getting a lot more attention. so this is something that requires us again to focus on a bipartisan basis and to solve. so, with that, i say thank you, and i yield back. >> i thank the gentleman. let me recognize the gentleman from virginia to inquire. >> mr. chairman, thank you very much. and, mr. secretary, it's so good to see that alums of these -- of the ways and means committee can turn out okay. so i'm encouraged for all of us. mr. secretary, while i was pleased to see the president's budget line for the suicide life line and the cdc climate program, i am concerned about the underfunding of the agency for health research and quality. for a president that wants to look at health inequities, the agency is this rare entity that actually looks at our healthcare system and tries to address the geographic and the racial and the ethic disparity. thanks for paying attention to that in the days to come.
mr. secretary, as you know the airlines have been pushing for digital health passes that can store vaccine certificates and the results of covid-19 and antibody tests. this will make it a lot easier to track the veracity of documents, avoid the need to check them physically at airports and not only that businesses will likely see digital health passes for their reopening. [ inaudible ] -- eu gateway for the eu digital covid certificates up and running. the system allows to verify certificates in a secure and privacy friendly way. will the u.s. be joining this effort, mr. secretary? >> congressman, great to see you. what i can mention to you is that i just came back from a meeting of the g7 health ministers. this was one of the subjects that was discussed. i think what we have done is explained to our colleagues in europe and asia and africa and latin america and throughout, what we intend to do is make
sure that our citizens will be able to meet whatever tests for verification and authentication that the country is asking for, a region might be asking for. although i think here in this country we've taken the approach that working with our private sector, we will try to make sure that we leave it to our local communities to decide what will be done to try to ensure the safety of all americans as we move forward. and, so, we believe that we'll have a solution that speaks to the acceptance of a method of verifying that will be useful for any american who wishes to travel to another country and for those wishing to come into the u.s. >> great, thank you. at the beginning of the pandemic, ireland sent a pamphlet to all of its citizens explaining covid with the stoplight system, you had the red, yellow green, the kinds of colored risk that we use for air pollution or forest fires. but i'm amazed that most americans were looking at
bloomberg and the "new york times" or the covid project for data rather than the cdc. and now that there is this great site called covid act now. i was just on it this morning. it's very intuitive and very accessible. even in virginia i can see that if i'm in alexandria my risk is very low. if i'm in carroll county, i'm in deep trouble right now. it'd be a great thing for the cdc to model so that we're turning not necessarily to a nonprofit but to the cdc to get that kind of data. and i recommend this covid act now website for your information. >> congressman, we will take a look and we look forward to working with you on these subjects. >> and one small pushback in the time left. i know my friend mr. arrington talked about title 42, but i know that president trump did invoke that over the objections of senior scientists at the cdc who argued that the ban lacked
and still lacks any medical or scientific justification. so i'd just ask that you use all due diligence to make sure it is still appropriate and it is not inappropriate to revoke title 42. and i yield back. >> i thank the gentleman. let me recognize the gentleman from georgia, dr. ferguson, to inquire. >> thank you, mr. chair, and mr. secretary for being with us today. you've said several times that you are very supportive of the administration's budget. but one of the areas that i want to talk about briefly is hr 3. i'm very concerned about the impact that that will have on innovation. very concerned about the impact that that's going to have on bringing cures for alzheimer's, diabetes, other things like that, you know, to the american people. but i'm also concerned about the loss of pharmaceutical manufacturing jobs. could you briefly tell me which
pharmaceutical manufacturing jobs you're willing to eliminate and send to china? >> congressman, thank you for the question. and i think we're actually going to see the number of jobs in this country increase as a result of some of the proposals that the president has, and if you take a look at the pharmaceutical -- >> but, >> but, mr. secretary, if you don't mind, i'm talking about specifically pharmaceutical manufacturing jobs. do you see with the lack of investment and innovation and the impacts of hr-3 we're going to lose those jobs. which jobs are you willing to sacrifice and send to china? >> as i was saying, we're in the business of increasing the number of jobs, including the pharmaceutical industry and, in fact, some of the moneys made available to the american rescue plan will make it possible for us to make that domestic commitment for manufacturing in the u.s. we look forward to working with you because we want any good -- >> so, mr. secretary, am i
hearing you correctly that if a piece of legislation would decrease manufacturing jobs in the u.s. you would be opposed to that? >> we are looking for ways to increase the number -- >> thank you. next, i know we've touched on this briefly. you've talked about the increase in funding for title 10 particularly around family planning. the elimination of the hyde amendments, hyde protections in the appropriations bill, do you think an increase in access to abortions and is this a desired effect of yours? >> what's most important is we all have access to the health care services we need and i will tell you we'll do everything we can to make sure that women or men or children do not get denied access to important care and we'll follow the laws. >> finally, again, you've supported the president's budget.
one of those items would prohibit -- the biden administration would prohibit funds used or spent and on stopping government networks and government employees from being able to view, download or exchange pornography. is that provision in the president's budget that you support? i think it's important given the amount of human trafficking at the border particularly and sex trafficking at the border. do you support the push to allow government employees to work while they're at work to view pornography, download it and exchange it? >> congressman, i will certainly say to you in this administration we will not only follow the law but we'll make sure it's enforced. i know of no provision in the budget that would allow anyone in the federal government to violate the law. no one has the authority to download the information which is illegal in nature.
>> i'll be happy to make sure that you get that information, the proposals that are in that budget. i worry about the elimination of cures that save american lives, increase funding, abortions that affect the life of the unborn, and making sure that we keep government employees from viewing pornography on the taxpayer dime. it sounds like you all have a lot of work to do. with that, mr. chairman, i yield back. >> let me recognize the gentleman from pennsylvania, mr. evans, to inquire. >> thank you, mr. chairman. mr. secretary, welcome and congratulations to you. in recent years we have been an increase in private equity, hospitals and nursing homes. one stark example is in philadelphia, acquisition, private equity firm which is described in detail in the current issue of "the new yorker
magazine." i ask for unanimous consent to include this article entitled [ inaudible ] in the record. as this details the private equity takes over, it is almost the most vulnerable who bear the cost. how do you view the ever-expanding role of private equity in the health care market and how can we medicare and medicaid to provide safety net hospitals and people who serve take over this? >> regardless of what your status, whether you're a provider, the federal government, our first and foremost priority are patients. for that reason it is important that every program that utilizes medicare and medicaid funding follows federal health and safety standards. and so when it comes to any federal -- any facility that uses federal funds, we're going
to make sure that they're accountable. and we don't want to see them taking advantage of safety net hospitals, stripping them of their assets, and essentially leaving all those families behind. and so i look forward to working with you as attorney general for the state of california, i was very aggressive and i can show up the record i had in trying to make sure if anyone wanted to buy a health care facility in my state, they'd better prove they were going to do it for the right reasons. >> mr. secretary, can you discuss the ways in which cms will improve marketplace services for consumers, a user fee across the marketplace functions and the increase -- [ inaudible ] >> is the gentleman muted?
>> and how user fees are -- >> mr. chairman, i'm not able to hear. >> we're unable to hear the question. would you try the question again, please? >> okay, mr. secretary -- >> i think you're having some technical difficulties. we'll go to brad snyder and we'll come back to you. >> thank you, mr. chairman. and thank you secretary becerra for coming before the committee today. it is quite wonderful to see you again. our country is in the midst of a long and difficult recovery. congress and the biden have are ready made movements in our
health care system. and and at the same time as you noted in your opening statement we are not out of the woods yet. president biden's budget bill on these achievements and provides the continued funding and planning needed to realize the goals of the american rescue plan. in particular i want to thank your agency and the administration as a whole for not just your focus but the prioritization supply chain management as it relates to the pandemic preparedness. i take note of the white house release today and its key findings and executive order of 14017 american supply chains and the creation of the supply chain disruptions task force. i've introduced legislation resiliency. i look forward to working with you to further advance this idea. i remember back almost 16 months ago when i asked your predecessor, secretary azar, about our critical supply chains in the face of the looming pandemic. my fears at that time were fully realized in the months
succeeding that and our supply chains failed to deliver vital products, personal protective equipment and testing supplies when our country needed them the most. since then the biden administration and congress have made incredible progress in shoring up our supply chains. we need continued planning and investment not just for covid but the next pandemic as well. secretary becerra, could you discuss your work to the production of supplies for the strategic national stockpile and what specifically we can do to help you achieve that goal? >> great to see you and thank you for the question. we saw what happens when you're not prepared. the last thing is make the mistakes of the past. our budget invests dramatically in trying to make sure that our stockpile is fit for the 21st century. we'll try to make sure we have those private and public
partnerships that are essential to make this work. we need to turn to the private sector to make it happen. and so we look forward to working with congress. we know we have a lot of work still to do to make sure that supply chain is ready for the 21st century, ready for prime time. we look forward to working with you. we certainly should use covid to give us the lessons that we can learn from to do this better. >> great. thank you. i look forward to continuing working with you on this. in particular another bill that was senator driven, i introduced the ppe in america act which would specifically have ppe and testing supply production and promote sustainable supply chains for this strategic national stockpile. is that something we can look to you to work together on? >> i look forward to working with you on that. >> thank you. and in the sake of time and respecting your visit here, i appreciate you joining us and yield the balance of my time back. >> i thank the gentleman. let's return back to mr. evans.
>> thank you, mr. chair. i recently reintroduced a bill and i'm pleased president biden's request proposed to work in congress. i look forward to working together. mr. secretary, can you explain why it's important to continue to expand the program? >> congressman, forgive me. please explain which program are we talking about? >> h-5. the health and opportunity grant program. >> i'm sorry, yes, the health professionals opportunity grant program. we have to do everything to expand and make sure our recipients and other low-income individuals with education and training for occupations in the health care field could be out there for us. i think this is a way to make sure we're addressing not only
our needs moving forward in terms of the workforce but will give opportunities to communities that have been neglected. >> i thank you, mr. secretary, for that. appreciate that. thank you, mr. chairman. i yield back. >> i thank the gentleman. let me recognize the gentleman from kansas, mr. estes, to inquire. >> thank you, mr. chairman and secretary becerra for appearing before the committee. instead of sending our nation on a path for fiscal instability, i have a concern that this wasteful budget would set us on a course for higher spending, more taxes and runaway debt. it increases nondefense spending by 16% and puts the annual deficit at an average of $1.3 trillion per year for the next decade. doubling the national debt over the next ten years. the results of the debt owed by each american raising 50% to around $120,000. i used to say that our children and grandchildren would be paying for our current lifestyle but, unfortunately, it's not
going to be our great-grandchildren that will bear the bunt of washington's out-of-control spending. instead of attempting to find common ground the budget is about raising taxes on every american in order to pay for some of these democrat, partisan, socialist policies. with all that massive spending it's easy to overlook what the $6 trillion doesn't address. basically safeguarding medicare for seniors. we know we're just five years away from medicare insolvency, a frightening statistic by itself. even more so after a global pandemic. in a trustees report for 2021 is significantly delayed. so many unknowns regarding the true cost of covid-19. it's possible that insolvency accelerated significantly. instead of protecting our current promise and fixing the insolvency issue this budget fundamentally changes medicare,
allows those 60 to 65 to increase medicare spending and proposes adding significant new benefits such as vision and dental without any tangible changes to ensure the delivery of current services. as we struggle to overcome and recover from the global pandemic it's more important than ever to help families and small businesses recover. ensure reckless spending in washington doesn't jeopardize the promises we've made to seniors. secretary becerra, fiscal 2022 hhs budget would increase spending by 21%. it's been mentioned before that there wasn't any money going to grants for any of the function spending in the next budget, but we're kind of concerned about the transparency and mischaracterizations of how some of the prior funding was directed towards the institute of virology. and we know they were involved in the gain of function research, which fundamentally changes what a virus can do.
what we're hearing a grant of $600,000 in nih funds through eco-health. can you confirm how much went to the wuhan institute of virology directly or through other companies? >> congressman, thank you for the question. i will simply echo what dr. fauci has said repeatedly, the nih never approved it. we are doing everything we can to make sure that those who received funding from nih are accountable for their funds. as i mentioned previously, the president has asked for an investigation about the source of the virus, the covid-19 virus. as i said as well, i, myself, called for, way before this became a controversy recently, for the world health
organization to do a second stage of investigations into this. and so i think -- by the way, i should mention that over the last several years some 100 scientists have been prevented, stopped from doing research with the nih over the course of time and in some cases we actually prosecuted and convicted some of these individuals. >> thank you, secretary. i wish we had more time. i would put an echo in for some of the telehealth in making that permanent. i am out of time so i will yield back, mr. chairman. >> i thank the gentleman. let me recognize the gentleman from new york to inquire. >> thank you, i don't know if lloyd is still on here. i want to thank you for pointing out one of the highest rates of uninsured children in the united states of america and our state of new york have some of the highest rates of insured children in the united states of america and one of the reasons our state and local taxes are so high and why it's so important. mr. secretary, thank you for
joining us. i don't know if you remember, you met me in 2016 when i was running for office. you should try and go on the ways and means committee. i never thought i would be so fortunate to be on this committee already. i'm so grateful to be here and for your service. thanks for everything you've done. people don't talk about the affordable care act. it's the consumer assistance programs. it was in the original affordable care act to provide money for state programs, state-based programs, to help consumers navigate the bureaucracy of health insurance. over 40 million denials of health insurance claims in 2019. most people don't appeal that. my parents, i remember them dealing with medical health insurance issues, so hard waiting on the phone trying to navigate. now we have this surprise billing protection that our chairman led the effort on along
with the ranking member. and people don't know they have those protections. i wrote a letter with 30 of my colleagues to the appropriations committee seeking $400 million to reinstate these consumer assistance programs that were defunded back in 2010. i want to know would you help us support the idea of funding consumer assistance programs? >> congressman, first, great to see you and congratulations on being on a great committee with so many good colleagues. absolutely we support that. this administration has already made major investments. we have provided funding for the navigator program which helps a lot of consumers know what kind of plan or policy to secure under the affordable care act. we have expanded the outreach and marketing of the affordable care act plan to consumers and the result is over a million americans have signed up for new plans. we will continue to do that
because we want americans to be good consumers and they need good information. we'll work with you to make sure that's done. >> we want to try to get more money put in for these state-based programs. i'm going to seek out your help to get that done. thank you, mr. secretary. i really appreciate it and thanks for your good advice. it's proven to be very helpful. >> mr. secretary, thank you very much. thanks, mr. chairman. thanks for being here. it's great to see you. it's unfortunate you left congress the same year that that i got in. fortunate enough for all of us that you are in this position now and were in california and now you get to fight for everybody across our country when it comes to our health care. thank you very much. i come from the central coast of
california and being from california yourself, you know how important immigrants and farmworkers are to our food security and who we are as a culture. obviously throughout the pandemic, they were on the front lines and met the definition of what it means to be an essential worker especially when it came to food security. unfortunately, at that expense, though, they were definitely susceptible to covid-19. that is why i believe it is critical we prioritize vaccinating our farmworkers as demonstrated in a recent "washington post" article on sunday that actually talked about what we have done here in the salinas valley, the salad bowl of the world. we came together. your help getting us vaccines here, my advocacy, the farmworkers, the farmers, the federally qualified health clinics, all came together.
we did our own mass vaccine sites that made sure our farmworkers are vaccinated or a significant amount of them are. we need your continued help with that. could you please describe other steps at hhs has taken to continue to address the unique health needs of both immigrant and farming communities? >> congressman, good to see you and thank you for continuing the great panetta tradition. what i can say is wind me up when it comes to what you just said. the best idea i can tell you about are the ones you are coming up with back home. we want to piggyback on what you are doing. you know where your families are that haven't been vaccinated. you know how to best reach them. you know who are the most trusted voices. whether it's the clergymen, the wrestling coach or the neighborhood watch leader. you know who has the confidence of the unvaccinated. we want to work with you and when it comes to farmworkers my
dad having been a farm worker at one point in his life, let me tell you, if you have more good ideas on how to reach them, we are there. >> outstanding. thank you, mr. secretary. we look forward to continue to work with you. a big issue as we get out of this pandemic is child care. with the upcoming infrastructure package, we want to make sure we have certain infrastructure projects that address that. can you share more about physical infrastructure projects needed and, more importantly available to all families? >> there are some great ideas. we want to not impose our idea. we want to support and fund the good ideas that are out there. so once again, because you know your district. we want to work with you so that the resources we hope will become available, some are
already available through the american rescue plan. we hope the investments made to help make sure kids have quality care so their parents can work, we want to work with you. you know where the successful models are and we want to make sure we're piggybacking so they can grow. i was out there and i visited a tremendously effective childcare center. they need to grow. they do it the right way. we want to build on helping all american families. >> i yield back, mr. chairman. thank you. >> thank you, mr. chairman. secretary becerra, congratulations. one is the power of the percent. every day americans -- since they've taken the majority in 2018, and when the president's budget was released my
constituents were furious he removed the department of health and human services' ability by removing the hyde amendment and spends more of their hard-earned money to increase funding for abortion providers. this carelessness over taxpayer money comes on the heels of congress appropriating nearly $4 trillion to fight the pandemic. and now more than 130 million americans are fully vaccinated it's time for congress to assess the spending impact. one of the largest looming threats is the exhaustion of the medicare trust funds, spending to accommodate the pandemic depleted funds by $5.8 billion. the latest predictions show medicare funds will run out by 2024, two years earlier than previously expected. without changes they would have to hike payroll taxes by some 26% or cut benefits by 16% to make the program solvent. according to the nonpartisan cbo if congress doesn't act,
benefits will need to be cut by $1,000 in order for our kids and grandkids to have access to the program. additionally i'm concerned that we have no details about the administration's so-called reforms to the very popular medicare program. my dear friend, the late senator tom coburn predicted long ago each step the democrats take to being involved in health care was a long-term plot to take away choice and enforce government-run health care. i fear we're getting closer to this reality every single day. not only does this get us closer and fails to address our looming debt crisis but does not reflect american priorities. i introduced a budget that balances in just five years and provides solutions like border security, medicare security and infrastructure, police and local safety. all of this without raising taxes. americans are concerned about the economy and filling jobs.
which president biden's budget makes no mention of. it talks about abortion, climate control, price controls and government subsidies that continue incentivized people to stay out of the workforce. the biden budget provides fully paid health care for biden's america who chooses not to go back to work. it also supports expanded subsidies which will inevitably prolong the absolute avoidable unemployment issue. i know what it is to compete against the government on the business community. i've witnessed firsthand how the party believes the best plan is to stick it to the backbone of our economy with their bloated spending bills. this will leave our kids and grandkids unable to pay the grandkids jobless and unable to pay the balance with zero
benefits. our jobs report and employers are struggling to fill jobs. drive down any main street and you'll see help wanted on the door. so why would president biden continue with subsidies that incentivize employees to stay home. mr. secretary a survey revealed the unemployment for small business is at a 40-year high. they make it more appealing not to go back to work. do you agree or disagree americans staying out of work is bad for the mental and physical health? yes or no. >> i know time has expired. we're in the business of creating more jobs and getting more people the health care they need. i do look forward to working with you. hopefully we will have a chance to work together in the future. >> thank you. >> let me recognize the gentleman from california, mr. gomez, to inquire.
>> thank you, mr. chairman. secretary becerra, it's good to see you, welcome back virtually to the committee. i don't need to describe my district to you. you're familiar with it. as you know, the district is a complex district. the haves and the have nots. people from all walks of life that come from different backgrounds, different languages, getting around by different means. and during the pandemic we saw the impact of covid-19 on the community i represent that was disproportionate compared to other communities. the data as you were aware that a lot of the covid-19 tests had not taken place on the east side of los angeles but on the west side. you saw it on the infection rates. you saw it on the death rates. i'm proud that we've been able
to turn the page but i believe it was foreseeable. and our policymakers and our institutions froze when it needed to turn quickly and pivot to a more equitable solution. we did that and i'm proud that california now has the lowest infection rate of any state in the country. but equities is key but it is very hard to do. very hard to do. no matter how much money you use it's about how you invest, target and implement. it is not always a straight line. i like equity because it can so many different people from so many different areas. it impacts people of color but it also impacts working class whites in rural areas as well. i know the health and human service focuses on health disparities.
and all health care programs. can you describe these programs and their goals and how will you ensure these programs work? >> it's great to see you. i see that those digs look really familiar to me. that office of yours. you've been able to come in and do a phenomenal job as a member of congress. >> somebody left me some nice furniture. by the way, thank you for all your work and trying to make sure our district, it's a tale of two cities in many ways. folks working together in many ways. president biden has spoken about
equity and made it clear he wants to see results. to now say we're going to demand results as well from the people and the programs we have at health and human services. one of the things we're doing, a couple of quick examples, the emphasis and the investment of real money turning into mortality and morbidity. we can take for granted that we have access to health care. some communities have women who are dying as a result of their pregnancy. the women who have terrible outcomes and it should surprise no one to know that happens in communities of color. there are things we're trying to do to address that. the investment the president -- i apologize, i see the time has expired. >> finish the thought, mr. secretary. >> any health services and the investment made in any health services we're going to make sure we're out there reaching
folks who for the most part have been in the shadows or in the corners of america. thank you. >> i thank the gentleman. let me recognize the gentleman from nevada to inquire. >> thank you very much. mr. chairman. and secretary becerra, it's great to see you. thank you for joining us today. i would be remiss if i didn't mention you have a great former staffer of mine, josie. she has always done great work and i know she will do so with you and on behalf of the american people. please tell her i said hi. mr. secretary, for my time i would like to talk about the importance of data collection. the chairman has designated the working group which helps to ensure policy proposals considered by the committee address economic and social inequities and advance racial justice.
helping us create meaningful legislation that improves the lives of the people that we serve. that change, though, starts with paying attention to the right metrics. we know the data collection can change human behavior and the way organizations operate. if we want to improve something we need to be able to measure it accurately. if we can measure equity accurately, then we can clearly see the progress that we're making over time. to do that we need to measure what matters. i'm talking about demographic matter. collecting the metrics will help us better understand the effect of structural racism and discrimination on health and economic well-being. in your testimony, mr. secretary, you highlighted that the covid-19 pandemic has shown the importance of producing reliable data. this congress i reintroduced my bill, the nursing facility
reporting act of 2021 which would require the centers for medicare and medicaid services to publish on the nursing home compare website certain demographic information aggregated by state with respect to covid-19 infections and deaths in such facilities. mr. secretary, in reference to the nursing home data bill, it's my understanding that this could be done administratively. i'm a strong advocate to collect reliable race, ethnicity data particularly for our most vulnerable populations and this would seem like an important part of an overall agenda. can you talk about what hhs plans are to move forward on this issue and can you describe the administration's plan to improve the underlying data systems at hhs with respect to
how we collect race and ethnicity data and other vital indicators to track health inequities? >> thank you. >> thank you for the question and for the work you're doing on this issue. as i have said, i used to say this a lot when i was attorney general of california. we depended on data, bad inputs produces bad outputs. if you're going to rely on the research that has been done but your data is flawed, you're going to start issuing really flawed conclusions and recommendations. we need to have good data and that will permeate the work we do at health and human services because we know how important it is to have data that can go beyond the generalized information and we can talk
about any other number of examples, diabetes. if we don't have clinical trials where we include all of the populations but especially those impacted by diabetes and you know and i know african-americans, latinos oftentimes we are -- it affects us more than other communities. your outputs, your results won't be very effective. we need to work together to make sure we do this right. >> the gentle lady from west virginia to inquire. >> thank you, chairman and ranking member and thank you, secretary becerra, for being here today. it's so nice to be able to meet you. we all can agree we want the best health care and access to those who need it the most at the most affordable price. we seem to have very different ways of accomplish these goals.
an approach to the administration's budget. i think we should focus on the patients, the cure and long-term solvency for our health care system. within this budget the president has called on congress to cut prescription drug prices. the plan hr-3 would result in fewer cures, as many as 100, i've heard. they will chill american innovation, actually raising prices on seniors and cost american lives. we cannot let such a disastrous piece of legislation reach the president's desk. the solution of hr-19 would lower the cost of drugs and further american innovation.
the pandemic has forever changed our health care landscape within west virginia. we saw many with increased access to care through telehealth. given the extremely rural nature of my state, patients sometimes had to travel hours to see a doctor and they were able to pick up their phone and meet with their provider. i heard from those providers who love it, too. they are able to see their patients more efficiently. i hope we can take the lessons learned and continue funding telehealth. i think it's so important. mr. secretary, can you commit to keeping this committee up to date with regular updates on the status of the provider relief fund specifically on how much money has yet to be distributed and how much has been returned
from the hospitals and providers, please? >> if i could just say i look forward to the chance to get to know you and work with you as you do your good work there. i hope you feel comfortable turning to me and the people on my team to help the people of west virginia. on the provider relief fund, we will do everything to be as transparent and accountable. much of the money has been released. but we're going to do with the money that remains is show you how it will be spent right and hopefully working with the providers in line to get some of that relief to make sure that they get it in time so you and i can say the taxpayers made a good investment in helping these providers there on the front lines helping americans recover from covid. >> okay, thanks. west virginia is such an incredible rural state. it's beautiful. telehealth across all
specialties has played a crucial role in ensuring a timely and quality access for us to have care. given this increased access to care for our most poor, vulnerable and elderly, what is the administration's plan to expand after the public health emergency ends? >> we're looking to take the lessons from covid that showed how telehealth became so important and working with you to provide more flexibility so we can make sure we get to folks in america. we want to make sure broad band is available to everyone. >> i have another issue -- am i cut off? >> not cut off but your time has expired. okay, maybe i'll send you a letter. thank you. >> thank you. >> let me recognize the gentle woman from the virgin islands to inquire. >> thank you.
i am so honored and excited to have the secretary with us as having had him as a mentor when he was a member of the house to see him and the leadership to the agency is something we're all looking forward to. mr. secretary, i have a number of seconds and wanted to summarize some of those related to the territories and your commitment to work with our office and the other territories regarding health care disparities as i'm sure you're aware the territories are again in limbo as they face the upcoming fiscal cliff in medicaid programs at the end of this fiscal year. this congress has supported the territories in eliminating the disparities we have not only in our funding caps as well as in
the share between the federal government and hospitals and local governments as well. something we don't talk about as much is the exclusion of the residents living in territories excluded from medicare prescription drug benefits as well as to the disproportionate share for hospitals dish program under medicaid and medicare in spite of the significant amount of uncompensated care and the number of individuals in rural areas. i was hoping that you would look at some of these issues and make a commitment to work with my office as well as other territories to find permanent solutions to some of those disparities. >> first, great to see you. great to see you in person a couple weeks bag and i look
forward to that more often. i think you know from my work when i was a colleague that the territories deserve to have our attention. the president's budget has support for eliminating the funding caps and tries to make sure we can align matching rates with states and so i look forward to working with you. >> thank you. the other question with regard to temporary assistance for needy families and the national issues, do you believe the funding levels are allocation of funds to states should be altered to account for a changed circumstance, inflation, poverty, population? what are your thoughts to allocations? >> that's a program that is supposed to meet the needs of
our neediest families and so we have to make sure that whatever our statutory framework is or anything we do regulations it's directed at trying to meet the neediest families. everything once in a while, the aging problem, we have to make adjustments so we refine our approach. we're more than willing to work with you and others if you think there's a better way to do this. we want to make sure our resources -- >> i know this has been an issue during the pandemic as work requirements and time limits on age. should some rules be suspended during the pandemic, but then once the pandemic ends, should those changes be made to work requirements to prompt states to engage in additional unemployment activities or should the changes be made to alter [ inaudible ] for families receiving assistance. do you have any policy ideas or thoughts for this congress on how we address the most neediest families in our country?
>> congresswoman, i know the time has expired so i will say this and we can follow up. we want to work with you. if you think there are ways we can move forward to address the needs of these families post-covid-19, we're willing to work with you. >> i thank the gentle lady. the gentleman from pennsylvania to inquire. is the gentleman on mute? >> there, can you hear me now? >> i can hear you. >> all right, thank you, mr. chairman, secretary, thank you for testifying for us today. i have some real concerns with president biden's budget. it manages to raise taxes on middle and low-income americans while simultaneously in a position where i think we're headed toward not being able to
make good on our promises and on a path to bankruptcy. i want to be sure the american people are hearing this. this raises taxes on all americans including those the president said he wouldn't raise taxes on. we know even the money raised through this is still not enough to pay for the proposals in the budget. this budget includes a provision to create a public option coupled with the $163 billion in subsidies in the plan to try to make the obama care plans more affordable. both proposals to nothing to lower the cost of health care, to boost innovation or to improve access. and what's more the budget includes promises to seniors by expanding medicare fee for service benefits without having the money to pay for those new benefits. i am concerned that will further erode medicare solvency and
drive up premiums in the medicare advantage plans. these ideas in this budget are bringing our nation one step closer to adopting a health care model that's used in socialist countries. and i believe that socialist medicine means fewer cures and delayed or, worse, even denied care, coverage does not equal access. there's a lot we can do to improve access and, by the way, i want to mention telehealth has been mentioned many times in this hearing. and i want to share one unique use for my district. i represent lancaster county in pennsylvania, which is home to tens of thousands of amish constituents, and i'm sure you're aware that they don't typically use electronics, but even among the amish -- seek necessary care during the pandemic and engaged in what they do is audio only telehealth visits. so telehealth is helping to reach underserved communities
throughout the nation. even like the amish in my area. if there is one area of bipartisan work that can be accomplished this year, i hope to work with the administration to make sure that we can continue to provide the access that telehealth has provided. and that doesn't go away at the expiration of the public health emergency. secretary, a public option is really a partial government takeover of our health care system. as i mention, i fear that will jumped mine the employer sponsor market and threaten medicare solvencies. providers are already facing cuts to the reimbursement rates and they'll be forced to charge the private market more just to make up for insufficient government payments. in turn, 157 million americans, by the way, currently obtain their coverage through the private market. they will likely see their premiums rise including seniors on fixed income.
in the meantime, we'll be pressuring physicians and hospitals to do more for less and i feel which will result in upheaval of the health care market. in fact, it might be the intent to quickly force us all into medicare for all. you a quick question. do you agree the underlying budget will let the tax cuts enacted under the jobs act for low and middle-income americans expire? >> thank you. i look forward to working with you in the future. please reach out to my team if we can be helpful in anything. the president's budget increases the opportunities for families. i hope we have a chance, since my time is expired, to go into that in detail. >> thank you. >> thank the gentleman. i want to thank secretary becerra for joining us today. i know he is on his way to the other chamber. as a lum, you'll be pleased to know we think you would be better off staying with us.
pleas be advised that members have two weeks to submit questions that will be in writing. those questions and your answers will remain part of the record. with that, the ways and means committee stands adjourned. >> thank you. c-span is your unfiltered view of government. we're funded by these television companies and more. including midco. sunday, c-span series january 6th views from the house
continues. three more members of congress share stories of what they saw, heard and experienced that day. including california democrat so did lofgren who served as a vote count that day. >> a capitol officer came and said it was necessary to evacuate. and that we should take the hoods, there are hoods under the seat of each seat in the chamber. take them out and be prepared to put them on. so everybody did. and i think when you pull the little red tag, it activates it. so people were not wearing them. there had been tear gas released in the chamber, in the row under the, the rotunda which was why we were advised we might need to wear them. but there was a tremendous
whizzing noise of the hoods. it was the background of the moment. and of course, the pounding and the noise from the mob had become much louder. at some point, someone up in the chambers, in the gallery, a member was yelling at the republicans to call trump and have trump call off his mob. and there was some little yelling back and forth among members in the gallery. >> call trump! call trump! tell him to do something. >> this week you'll also hear from republican rodney davis of illinois and pennsylvania democrat madeleine dean. january 6th, views from the house. sunday, 10:00 p.m. eastern on
c-span, c-span.org or leonard on the radio app. veterans affair secretary denis mcdonough was on capitol hill for the hearing on the president's 2022 budget request. he testified on how additional funding would be used to address a growing backlog, infrastructure improvements and staffing shortages. they also heard from advocacy groups about the shared priorities for helping veterans.